Revenue Cycle Staffing Challenges: Financial Strategies for FQHCs 

Supporting your Mission Starts With Supporting the Team 

Across the country, FQHCs are feeling the strain of a workforce stretched too thin. Billing departments are understaffed, coders are burning out, and hiring qualified revenue cycle talent feels harder than ever. For CFOs and Revenue Cycle Managers, this isn’t just a staffing issue, it’s a financial one. 

When your team is under-resourced, it shows up in your bottom line: missed revenue, higher denial rates, and lagging A/R. And in a year where every dollar counts, operational inefficiency isn’t something most health centers can afford. 

But staffing challenges don’t mean your mission has to take a hit. With the right financial strategies, FQHCs can protect staff wellbeing and strengthen long-term sustainability. 

The True Cost of a Short-Staffed Revenue Cycle 

It’s easy to think of staffing gaps as a temporary inconvenience, but the financial impact can be substantial. Burnout leads to turnover. Turnover leads to errors. Errors lead to lost revenue. 

• Coders and billers are in short supply. 9 out of 10 healthcare executives report shortages in medical billing and coding professionals, and 63% are actively facing staffing shortfalls in their revenue cycle teams. 

• Burnout drains both people and profits. Replacing an experienced coder can cost up to 200% of their annual salary. And while you search for a replacement, unpaid claims pile up. 

• Workload is growing faster than staff capacity. CMS made 230+ CPT code additions in its most recent annual update. That’s more work, more complexity, and higher demands on already thin teams. 

When staff are exhausted, even the best systems break down. Denials increase. A/R balloons. Claims are left unsubmitted or under-coded. It’s a vicious cycle – and one that can quietly erode your revenue month after month. 

Strategies That Support Financial and Staff Health 

RCM isn’t all doom and gloom though! While there’s no one-size-fits-all solution, there are smart, proven steps FQHCs can take right now to stabilize their workforce and protect their financial future. 

1. Invest in Retention Before You Have to Invest in Replacement 

Turnover is expensive. Building a culture of retention saves money and strengthens your team from within. 

• Offer cross-training and development opportunities – especially in billing and coding – so staff feel they can grow without leaving. 

• Create realistic productivity goals tied to quality, not just quantity. Overworked staff are more likely to make mistakes that lead to denials. 

• Consider flexible scheduling, remote work or hybrid options when possible. Small changes can reduce burnout and increase loyalty. Offering the kinds of working conditions that quality billers and coders are looking for makes your FQHC more attractive to top candidates. 

2. Automate Where It Makes Sense 

You don’t have to automate everything. But a few strategic tools can give your staff breathing room. 

• Use eligibility verification tools to reduce manual work at the front desk and cut down on claim errors. 

• Implement denial management software that flags trends and helps prevent repeat issues. 

• Track A/R in real time using user-friendly dashboards to reduce manual reporting and speed up corrective action. 

3. Outsource Without Losing Control 

Outsourcing doesn’t mean losing your mission. In fact, it can be one of the most mission-aligned decisions you make, especially if you find a company that understands the FQHC landscape and the improtance of operating in a mission-first culture. 

• AR cleanup and denial resolution are high-impact, low-disruption services that can recover revenue without pulling your team away from current claims. 

• Full RCM outsourcing provides access to certified coders and billing experts without the overhead of recruiting, onboarding, or backfilling staff. 

• The right RCM company will feel like an extension of your internal team, not a replacement for it. 

Resilient Teams Deliver Sustainable Care

FQHCs are built to serve their communities. That mission hasn’t changed, but the environment has. Workforce shortages, policy uncertainty, and funding challenges are pushing teams to the limit. 

The solution isn’t to push harder. It’s to work smarter. By rethinking staffing strategies, improving processes, and exploring support options like outsourced RCM, FQHC leaders can protect their teams, reclaim lost revenue, and keep their organizations strong for the communities that rely on them. 

Want to explore how outsourced RCM can strengthen your team and your bottom line? Let’s talk.