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How Do Health Systems Fill 30 Plus Revenue Cycle Vacancies When Local Hiring Has Failed?

The seats are posted. The req has been open for six months, you raised the pay band, you added a signing bonus, and you still filled two of twelve.

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All Pain Points
SOLUTIONThe fix is to size the gap by function, stand up a dedicated remote team covering coding, billing, AR, and eligibility as a permanent seat, cut the agency spend running triple your budgeted cost, and build coverage so a person leaving never reopens the hole.
Written for Revenue Cycle VPs, Directors of Operations, and Finance Leaders evaluating enterprise RCM outsourcing.

Health systems cannot fill 30 plus revenue cycle vacancies through local hiring because the supply of credentialed coders and billers no longer meets demand, and remote work turned that shortage national: your regional system now bids against payers and large health systems for the same small pool, and raises plus signing bonuses have not closed the gap. The fix is not another job post. It has four moves: stop treating the vacancy as a recruiting miss and size the real gap by function, stand up a dedicated remote RCM team that covers coding support, billing, AR follow-up, and eligibility as a permanent seat rather than a temp patch, cut the agency spend that is quietly tripling your cost per hour, and build the coverage so a person leaving never reopens the hole. We run those teams inside the systems you already use, whether you are on Epic, Cerner, or Meditech, so the AR queue gets worked while the reqs stay open or close for good. The table of contents below maps the whole method; the moves after it are the detail.

What Actually Closes a 30-Seat Revenue Cycle Vacancy Gap

The goal is a revenue cycle that gets fully worked whether or not your local reqs ever fill: coding, billing, AR, and eligibility all covered, at a cost you budgeted for instead of triple it. Here is what does that, move by move.

1. Size the Real Gap by Function, Not by Headcount

Thirty open seats is not one problem; it is four. Before you chase another hire, break the vacancy down by function: how many coding-support hours are unworked, how much AR is aging past 90 days for lack of a follow-up team, where eligibility is failing upstream, and which billing queues are backing up. A raw headcount number tells you nothing about where the revenue is leaking. Once the gap is sized by function, you can cover the parts that are bleeding first instead of waiting on a single perfect local hire who may never come.

2. Stop Bidding Against the National Market for a Local Seat

The reason the req will not fill is not your recruiter. Remote work erased geography, so your regional pay band is now competing with national payers and large systems for the same credentialed coders. You cannot out-bid that pool one seat at a time, and every month you try, the agency clock runs. The move is to stop treating this as a local hire at all and source the coverage from a dedicated remote team built for exactly this work, so the reqs stop being the thing standing between you and a worked queue.

3. Stand Up a Dedicated Remote RCM Team as a Permanent Seat

A temp agency plugs a hole for a week; a dedicated remote team closes the gap for good. The move is to place credentialed remote team members who own coding support, billing, AR follow-up, and eligibility as their actual job, working inside your Epic, Cerner, or Meditech environment, not as a stopgap you re-source every quarter. This is where a dedicated team beats both the open req and the agency: the same people learn your payers, your service lines, and your denial patterns, and they stay.

4. Cut the Agency Spend That Is Tripling Your Cost per Hour

While the seats sit open, agency and traveler rates are quietly running at two to three times the budgeted cost per hour just to tread water. That spend does not build anything; it rents a body for a queue. Redirecting it to a dedicated remote team lowers the cost per hour and buys continuity instead of churn, so the money you were burning to stay flat starts actually closing AR days and clearing the coding-lag backlog.

5. Hand the Vacancy Gap to a Dedicated Outsourced Team

Systems that stop losing months to unfillable reqs do it by handing the gap to a dedicated outsourced RCM team: credentialed remote coders, billers, AR, and eligibility specialists, live in 1 to 2 weeks. The AR queue starts getting worked inside the first week, the agency spend comes down, a trained backup covers every gap, and your internal leaders stop managing an open-req crisis and start managing a revenue cycle again. Below is what it sounds like when nobody has closed this gap yet, in revenue cycle leaders' own words.

Key Pain Points and Discussions by Providers

representative composite examples based on common workflow discussions

“I have had twelve coder seats posted for six months and filled two. It is not the offer. Every qualified person we reach is already working remotely for a payer or a bigger system, and we cannot match that band on a regional budget. The req stays open and the queue keeps growing.” composite example: revenue cycle director, regional health system

“We raised pay and added signing bonuses and it barely moved the needle. The people we need are not looking, because they already have the remote job we are trying to offer them. You cannot hire your way out of a shortage this size with money we do not have.” composite example: director of patient financial services, hospital

“The part nobody sees on the org chart is what the vacancy costs. AR days climbed nine days while the seats sat empty, coding-lag denials piled up, and we were paying agency rates triple the budgeted cost per hour just to keep from drowning.” composite example: CFO, community hospital

“Every temp we bring in has to be retrained on our payers and our system, and then they leave and we do it again. It is churn dressed up as staffing. What we actually need is a team that stays long enough to learn our denial patterns.” composite example: revenue cycle manager, multi-site system

“I stopped calling it a hiring problem. It is a supply problem. The credentialed coders do not exist in the numbers we need in our market, and posting the same req louder does not create them.” composite example: VP of revenue cycle, health system

Our Answer

Here is what we actually do. We place a dedicated remote RCM team that owns the functions your reqs cannot fill: coding support, billing, AR follow-up, and eligibility, working inside your Epic, Cerner, or Meditech environment as a permanent seat, not a temp patch you re-source every quarter. We size the gap by function first, so the aging AR and the coding-lag backlog get worked before anything else, and the agency spend that was running triple your budgeted cost per hour comes down. Our team members are trained healthcare operations professionals, team members with healthcare backgrounds that may include medicine, nursing, and pharmacy alongside certified coders and billers, with approved AI tools assisting with first-pass on repetitive work and a human verifying every claim and code. Within the first week the AR queue starts moving instead of aging. This is our revenue cycle management support built as dedicated staff, in one paragraph.

Why This Keeps Happening

If the pay is competitive and the recruiters are working, why will the seats not fill? Because the shortage is real and national, not local to your market. The American Academy of Professional Coders reports that demand for credentialed coders is projected to outpace supply by more than 30 percent through the end of the decade, and the American Medical Association has cited a national coder shortage in that same range. There are not enough credentialed people to fill every open seat, and posting the same req louder does not create them. Closing that math is exactly what a dedicated medical coding support team is built for.

Remote work is what turned a shortage into a bidding war you cannot win. The coders and billers you need are no longer bound to your region; they can work from anywhere, and industry survey data shows the large majority of credentialed coders now work fully remote. That means your regional pay band competes head to head with national payers and large health systems for the same small pool, and MGMA has reported that billing and coding roles were among the biggest turnover hotspots in 2025 as people moved to higher-paying remote positions. Your open req is not losing to a better local employer; it is losing to the entire national market at once.

And the cost of the open seat is not neutral while you wait. HFMA has reported that revenue cycle leaders can no longer staff their way out of these shortages, because volumes rise while FTEs stay flat and the administrative burden grows. Every month a coder or biller seat sits empty, AR ages, coding-lag denials stack up, and the agency or traveler rates brought in to tread water run at two to three times the budgeted cost per hour. The vacancy is not free while you recruit; it is the most expensive line in the revenue cycle, and it compounds. A dedicated accounts receivable follow-up team is what stops the aging while the reqs resolve.

⚠️ The quiet one that hurts most: The quiet one that hurts most: the agency spend that never shows up as a vacancy. On paper the seat is empty and the budget line looks like a savings. In reality you are paying travelers and agency rates at two to three times the budgeted cost per hour to keep the queue from collapsing, and that spend builds nothing, because the moment the contract ends the knowledge walks out with the temp. Unless someone owns those functions as a permanent seat, the vacancy keeps costing you full price plus a premium, quarter after quarter, while looking like an open req you are about to close.

Most groups have already tried the obvious fixes before they talk to anyone. Each one fails the same way: the work lands back on the practice. The pattern, in one table:

What you tried What actually happened Who ended up doing the work
Raised the pay band and added signing bonuses Barely moved the needle; the people we need already have remote jobs paying more The recruiters, still working a pool that is not there
Brought in agency coders and travelers Kept the queue from drowning at two to three times the budgeted cost per hour, and they left with the knowledge A rented body, quarter after quarter
Moved internal staff to cover the open functions Robbed one queue to feed another; AR aged wherever the person was pulled from Whoever was closest to the fire that week
Handed the gap to a dedicated remote RCM team Coding, billing, AR, and eligibility worked inside our system as a permanent seat, agency spend down, queue moving A team whose whole job it is

The Solution

So what does "a team whose whole job it is" look like across 30 open seats? It starts where recruiting cannot: we size the gap by function, then place credentialed remote team members who own coding support, billing, AR follow-up, and eligibility inside your Epic, Cerner, or Meditech environment. The aging AR and the coding-lag backlog get worked first, because those are where the revenue is actively leaking. This is not a temp plugging a hole; it is dedicated revenue cycle management staff learning your payers and your denial patterns and staying long enough that the learning compounds instead of walking out the door.

Then comes the part the agency model never delivers: continuity. The same people work your queues week after week, so they know which payers deny for coding lag, which service lines run hot, and how your eligibility fails upstream. The agency spend that was running triple your budgeted cost per hour comes down, and the money that was renting bodies starts actually closing AR days. Your internal leaders stop managing an open-req crisis and go back to managing a revenue cycle, because the functions the reqs could not fill are covered and worked.

Behind all of it, Approved AI tools may assist with the first pass on the repetitive work and a trained human reviewer verifies. The workflow assembles claims, flags coding gaps, and surfaces underpaid accounts; a person confirms the code is right and owns the account. Every security control that protects the patient financial data moving through that process is documented and auditable, and the whole approach is described on our HIPAA and security page, because moving PHI through a revenue cycle workflow is only safe when the controls are real.

Who Actually Does This Work

Fair question: why would an outsourced team work your coding and AR better than the coders you cannot hire locally? Because the supply problem that empties your reqs does not exist on our side, and this work is their entire day. The people covering your revenue cycle are trained healthcare operations professionals: certified coders and billers, overseas-trained physicians, and US-licensed nurses and pharmacists, all trained in US revenue cycle, payer rules, and denial workflows. They are not a generalist covering AR between other duties; working your queues is the job, across many systems, so the pattern recognition that takes a new local hire months to build is already there.

We are not a temp agency. We are a clinical operations partner, a healthcare BPO built on dedicated virtual staff: 500+ team members, 24/7 coverage, and the AI-assisted plus human-verified workflow you just read about behind every one of them. A typical system is live in 1 to 2 weeks, at approximately 68% below equivalent in-house staffing costs. Trained backup coverage is included in the managed-service model.

And the security piece your compliance officer will ask about: Staffingly maintains active ISO/IEC 27001:2022 certification and operates under HIPAA-compliant controls and signed BAAs. SOC 2 Type II reporting and security controls apply according to the relevant entity, client environment, facility, device, and workflow. Venn Blue Border and related workstation restrictions are used where applicable. Staffingly maintains $5M in professional liability (E&O) and cyber insurance as part of its enterprise risk-management program; the full detail lives in our HIPAA and security posture.

Put the routine and the people together, and a specific list of things simply stops happening.

✓ What this workflow is designed to reduce: What this workflow is designed to reduce: the req that stays open for six months and fills two of twelve seats. AR days climbing while the coding queue backs up for lack of a team. Agency rates at triple the budgeted cost per hour just to tread water. The temp who learns your payers and then leaves with the knowledge. The revenue cycle leader who spends every week managing an open-req crisis instead of the revenue cycle. The vacancy that quietly becomes the most expensive line on the schedule.
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How We Build a More Durable Process

A single hire is not the fix, and neither is a rotating cast of temps. The fix is a documented revenue cycle coverage plan: which functions are staffed by the dedicated remote team, exactly how coding, billing, AR, and eligibility are worked, which payers deny for what, and where the queue hands off. Before we work a single account for a new system, we chart your open functions and your AR aging by payer so we can see where the revenue is actually leaking, and we build coverage against that, not against a generic staffing template.

From there the coverage becomes a living playbook rather than knowledge trapped in one coder's head. It records how each payer wants claims coded and billed, which denial reasons recur on which service lines, how eligibility should be verified upstream, and the exact escalation path when an account stalls. It is written down, kept current as payers change their rules, and owned by the team. When a team member is out, a trained backup works the same playbook the same way, so a worked queue never reopens because one person left.

That is the difference between chasing this quarter's open reqs and fixing the process for good, and it is what a dedicated revenue cycle management partner actually buys you. A coder leaving used to mean the seat reopened and the AR aged again. Under this model the coverage keeps running, the playbook stays, the backup steps in, and a 30-seat vacancy gap stops being the crisis that eats every quarter.

The Whole Thing in Four Sentences

Health systems cannot fill 30 plus revenue cycle vacancies through local hiring because credentialed coder and biller supply lags demand, and remote work turned that shortage national: your regional pay band now bids against payers and large systems for the same small pool, and raises plus bonuses have not closed the gap. Posting the req louder, renting agency travelers, or robbing one queue to cover another all fail the same way. The fix is to size the gap by function, stand up a dedicated remote team covering coding, billing, AR, and eligibility as a permanent seat, cut the agency spend running triple your budgeted cost, and build coverage so a person leaving never reopens the hole. A regional health system can use this workflow without exposing patient information or naming client organizations.

If you want to check us out before talking to anyone: our security posture is independently auditable, we are an MGMA 2026 Corporate Member, and 800+ providers run back office work with us.

Ready to close your revenue cycle vacancy gap? Start with a Two-Week Free Trial: your real AR aging and coding backlog, a dedicated remote team working the functions your reqs cannot fill, and if it does not earn the handoff, you walk away. From here down is the sales part, and it is short: here is exactly what it costs.

Transparent Weekly Pricing

One Flat Weekly Rate. 45 Hours of Coverage.

No hourly meters, no setup fees, no security deposits, no long-term contracts. Two-Week Free Trial. Your dedicated team member covers your desk 45 hours every week, and a trained backup steps in at no charge whenever they are out.

Single
$399/ week

One dedicated remote RCM team member covering coding support, billing, or AR follow-up for a single hospital department or specialty service line

Department
$299/ week

10+ remote RCM team members, multi-hospital health system, MSO, or PE-backed platform closing vacancy gaps across coding, billing, AR, and eligibility at once

  How Pricing Works

45 hours of coverage at one flat weekly rate.

For a simple annual comparison, 40 hrs x 52 weeks = 2,080 hours. A Staffingly plan: 45 hrs x 52 weeks = 2,340 hours a year, that is 260 additional hours included in your flat rate. $399/week x 52 = $20,748 a year / 2,340 hours = $8.87 per hour.

Trained backup VA Dedicated success manager Monthly training updates HIPAA-trained staff $5M E&O and cyber liability

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Frequently Asked Questions

Because the shortage is national, not local. The American Academy of Professional Coders projects demand for credentialed coders to outpace supply by more than 30 percent through the end of the decade, and the AMA has cited a coder shortage in that same range. Remote work means the credentialed people you need are already employed by national payers or larger systems, so your regional pay band is bidding against the entire market for a pool that is too small. Posting the same req louder does not create coders who do not exist.
A temp agency rents a body for a queue and re-sources it every quarter, so the person who learns your payers and denial patterns leaves and takes that knowledge with them. A dedicated remote team owns coding, billing, AR, and eligibility as a permanent seat inside your own system, so the same people stay long enough that their learning compounds. It is continuity instead of churn, at a lower cost per hour than agency or traveler rates.
More than the empty budget line suggests. While the seat sits open, AR ages, coding-lag denials stack up, and the agency or traveler rates brought in to tread water typically run at two to three times the budgeted cost per hour. HFMA has reported that revenue cycle leaders can no longer staff their way out of these shortages, because volumes rise while FTEs stay flat. The vacancy is not free while you wait; it compounds.
Coding support, billing, accounts receivable follow-up, and eligibility, worked as dedicated seats rather than a stopgap. We size the gap by function first, so the aging AR and the coding-lag backlog get worked before anything else, and the team members learn your payers, service lines, and denial patterns the same way an internal hire would, except they stay.
Staffingly charges $399 per week for one dedicated team member, $349 per week each at 5 or more, and $299 per week each at 10 or more. The dedicated-team model includes 45 hours of weekly coverage where applicable to the service schedule, with trained backup coverage included. There are no setup fees, no security deposits, no long-term contracts, and no percentage of collections. Every engagement starts with a Two-Week Free Trial.
No. Approved AI tools may assist with the first pass on the repetitive work, assembling claims, flagging coding gaps, and surfacing underpaid accounts, and a trained human reviewer verifies every code and claim and owns the account. The clinical and coding judgment stays with people. Automation removes the repetitive assembly so specialists spend their time on the accounts that need a human.
No. Our team members work inside the Epic, Cerner, Meditech, or billing systems you already use, so there is no migration and no new platform for your staff to learn. They work your accounts where they already live, which is why a typical system is live in 1 to 2 weeks rather than months.
Usually within the first week. Once a dedicated team is working coding, billing, and AR follow-up inside your system, the accounts that were aging for lack of a follow-up team start getting worked, and the coding-lag denials that were stacking up start clearing on resubmission instead of sitting in a queue nobody owned.
Your dedicated specialist works a 9-hour day, Monday to Friday, which is 45 hours of coverage each week. The ninth hour is part of the flat weekly rate, not billed as overtime. Over a year that is 2,340 hours of coverage, compared with 2,080 hours from a simple 40-hours x 52-weeks annual calculation. That is how $399 per week works out to $8.87 per hour.
Dan Nandan, Founder and CEO of Staffingly, Inc.

Written By

Dan Nandan
Founder and CEO, Staffingly, Inc. · Piscataway, NJ

Dan Nandan is the Founder and CEO of Staffingly, Inc., based in Piscataway, New Jersey. He has 25+ years in IT consulting and IT staffing, with the last decade focused on healthcare outsourcing. He was among the first to establish an RPO operation in India more than 20 years ago and has been featured in Computerworld. He leads Staffingly's U.S. clients and delivery teams behind the workflows described on this page.

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This page is general educational information for healthcare operations teams. It is not legal, medical, billing, coding, or compliance advice, and it does not create any professional or advisory relationship. Payer rules, codes, forms, and regulations change and vary by plan and region, so confirm every requirement with the applicable payer or authority before acting. Staffingly, Inc. makes no warranty as to accuracy or completeness and accepts no liability for decisions made based on this content.

Where the Claims on This Page Come From

Sources & References

  • American Academy of Professional Coders (AAPC) Workforce and Salary Data. Reporting that demand for credentialed medical coders is projected to outpace supply by more than 30 percent, and that most credentialed coders now work fully remote. aapc.com
  • HFMA Revenue Cycle Staffing Coverage. Reporting that revenue cycle leaders can no longer staff their way out of persistent coder and biller shortages, and are turning to automation and outsourcing. hfma.org

Key highlights of every Staffingly engagement

You pay for the resource. Everything else is included.

Your flat weekly rate covers one dedicated specialist. The management layer around them, backup coverage, quality reviews, training, escalation, reporting, and custom automation comes standard at no added cost. Here is what every Staffingly account includes.

See the 8 things every account includesHide the 8 inclusions
  • Who manages my account day to day?

    An account manager plus a customer success manager. Two named people own your account: the account manager runs daily operations and quality, the customer success manager handles onboarding and communication tools like ClickUp or Teams, so your team never chases an answer.

  • What if something needs to go higher?

    VP-level escalation, US and offshore. A direct path above your account manager to Vice President level leadership on both sides, US-based and at our offshore delivery centers. You are never stuck in a ticket queue waiting for someone with authority.

  • What happens when my specialist is out or leaves?

    Backup coverage and same-week replacement. A cross-trained backup covers absences so your work never sits idle. If a specialist leaves or underperforms, we replace them the same week, trained on your workflows before the handoff.

  • How are holidays and leave handled?

    Planned in advance. Specialists receive approved US holidays and two weeks of paid leave per year. Coverage for those dates is arranged with you ahead of time, so continuity is planned, not improvised.

  • How do I know the work is getting done?

    Daily quality stand-up plus daily and weekly reports. Every account starts the day with a stand-up: what came in, what went out, what is stuck, and who is fixing it. You get a daily activity report and a weekly performance report, so nothing slips for a month before you hear about it.

  • How are specialists trained before they touch my account?

    AI-enabled, HIPAA-controlled training. Specialists train in simulations of your EMR and workflows inside our secured environment, with quizzes requiring an 80 percent passing score and AI-moderated final assessments. See how our training works.

  • Do I pay extra for automation?

    No. Custom AI and automation workflows are free. We build automation around your account at no charge: document intake, EMR data entry assistance, and status tracking, always with human review. Faster turnaround and fewer errors reaching the payer, without an extra software bill.

  • Will my rate change, and how do I add people?

    12-month price lock, easy scaling. Your rate is fixed for twelve months from your start date. Need more agents later? An email from your authorized representative is enough. Once confirmed in writing, new agents fall under your existing agreement. No new contract, no work order.

Dedicated specialists, never shared, working inside your EMR and payer portals under a signed BAA. One flat weekly price per operator covers all of the above.Book a Strategy Call