Tips to find, hire, and maintain front-end help

"Look at 24-hour industries," Calvaruso says. "Customer service reps from electrical companies, for example, have to do a lot of things. Hotel front desk [workers] fit in the same concept. They have a financial responsibility to the company. They assign beds and need to have strong customer service skills. Also look at the airline industry. They have workers who assign a place, a seat, a spot, and they're also responsible for collecting money."

Show me the money

Use www.salary.com as a tool to gauge the average salaries of workers in different industries in your region. "I use this all the time," Calvaruso says. "Put in your ZIP code, and look at key duties for a specific position and compare it to the key duties of the position you're trying to fill."

In most cases, you'll find that you pay an average of 30%--35% below what other industries pay for their help, Calvaruso says.

Calvaruso recently compiled information from the Baltimore area. She found that customer service reps in that region receive hourly wages ranging from $14.78 to $18.93.

For bank account clerks, the wages ranged from $11.39 to $14.65. For billing clerks, the wages ranged from $13.49 to $17.49. And for travel agents, the wages ranged from $10.79 to $13.07.

The conclusion you'll most likely reach is that your CEO should invest more money in better help. Use these salary figures; combine them with your internal numbers of denials, bad debt, and benchmarking errors; and present the data to your CEO.

"You can't go to your CEO with anecdotal information--you have to go to [him or her] with proof. You need to have some teeth behind what you are saying," Calvaruso says.

Take an active role in improving your department. "A lot of times, [managers] feel their hands are tied," Calvaruso says. "They don't always feel they have support from management on whom they can and should hire, as far as salary caps are concerned."

Present a compelling case to your CEO. Talent doesn't always come cheap.

"They should realize that for talent they are not only competing with [other hospitals] but also with other industries. Facilities are going to have to compete with these other industries or deal with increased denials and bad debt," she says.

Don't you have any standards?

You've identified the problem, targeted candidates from either your own talent pool or another industry, and set out to hire one or more of these candidates. But the process isn't over yet. The selection process should be complete and thorough, Calvaruso says.

"[Managers] are so busy trying to find someone who can actually just fill a seat that they are not necessarily finding the right people," she says. "They're just looking for a warm body because they probably weren't prepared for the vacancy."

Look for more than nice people with good customer service skills. "If they can't type a minimum of 45 words per minute, don't [hire them]," she says. "Take your time, interview them properly, and make the right decisions."

Once you've hired them, do your best to eliminate turnover.

Improving your front-end efficiency takes more than just a financial commitment, Calvaruso says. "Make them key components of your facility. Don't let them get blamed for everything, but make sure they realize that a facility's revenue cycle starts at the front end. You really need to be concerned with how that money is spent. Take the time and invest it wisely."