Beyond Automation: The Need for Human Skills in an Evolving RCM Landscape

As technology continues to transform healthcare, particularly in revenue cycle management (RCM), the conversation around automation, outsourcing, and workforce evolution is growing. A recent HealthLeaders Media article, Hand in Glove? How Nascent Tech Stands to Shape RCM Outsourcing, highlighted the increasing role of automation and outsourcing in RCM. While these shifts may change where jobs are located, they do not necessarily eliminate them. Instead, they reinforce the need for professionals with strong critical thinking, problem-solving, and interpersonal skills, which are so important and which technology cannot replicate.

The discussion surrounding artificial intelligence (AI) and robotic process automation (RPA) often centers on efficiency, cost savings, and increased accuracy. These advancements can streamline billing, coding, and claims management, reducing manual tasks and improving workflow efficiency. However, technology is not everything. Even the most sophisticated AI cannot function without human oversight, nor can it replicate important decision-making, adaptability, and ethical judgment.

While automation excels at repetitive, rules-based tasks, the complexities of healthcare require human expertise. For instance, when coding rules change, reimbursement models shift, or new regulatory requirements emerge, professionals must interpret these changes and apply them appropriately. AI can assist, but it cannot understand the broader context or make judgment calls the way a skilled health information (HI) professional can.

The HealthLeaders Media article underscores an essential point: to stay relevant in this evolving landscape, RCM professionals, and the broader health information workforce, must strengthen their critical thinking and problem-solving abilities. These are the skills that allow professionals to analyze complex situations, identify solutions, and make informed decisions in ever changing environments.

As AHIMA and other organizations develop professional development programs, it is essential to ensure that critical thinking is not just an afterthought, but an integral component of learning objectives. Traditional training programs in HI have focused on technical competencies such as coding and compliance. While these remain important, they must be accompanied by additional learnings that foster more complex critical thinking skills.

For example, instead of solely teaching students how to apply codes based on predefined rules, professional development should challenge them with real-world scenarios that require analysis and judgment. What happens when documentation is unclear? How do they handle conflicting information from different providers? These types of questions encourage them to think critically about the challenges they will face in the workplace.

The Value of Communication and Teamwork

Beyond critical thinking and problem-solving, soft skills, such as communication, teamwork, and emotional intelligence are extremely valuable in today’s healthcare landscape. While AI can process data, it cannot build relationships, collaborate effectively, or lead teams through change.

Soft skills are particularly important in roles that require collaboration across departments, such as clinical documentation improvement (CDI), compliance, and revenue integrity. Professionals in these roles must communicate with physicians, administrators, and IT specialists, ensuring that clinical and administrative data align. The ability to communicate complex information clearly, listen actively, and build trust is just as critical as technical expertise.

Additionally, emotional intelligence, which is the ability to understand and manage one's own emotions while recognizing and influencing the emotions of others, is a key leadership trait. In high-pressure environments like healthcare, where regulations change frequently and financial stability is at stake, the ability to remain calm, adaptable, and empathetic can make a significant difference in team dynamics and decision-making.

Another key takeaway from the HealthLeaders Media article is that while outsourcing in RCM is increasing, it does not mean that jobs are disappearing. It means they are shifting. As companies rely more on global partners, the role of US professionals may evolve to focus more on oversight, quality control, and strategy rather than routine transactional tasks.

This shift further emphasizes the need for advanced problem-solving skills. HI professionals must be able to assess the impact of outsourcing decisions, monitor key performance indicators, and ensure compliance with regulations across different regions. They must also be prepared to handle challenges that arise when working with external teams, such as communication barriers, data security concerns, and differences in work culture.

Workforce development efforts should then focus on preparing professionals for the roles of tomorrow, not just the tasks of today. This means equipping them with the ability to think critically, communicate effectively, and adapt to new responsibilities as the industry continues to evolve.

Given these industry trends, we must:

1. Integrate Critical Thinking into Training Programs: Educational institutions and professional development programs must prioritize the development of critical thinking skills through case studies, real-world problem-solving exercises, and scenario-based learning.
2. Emphasize Soft Skills in Workforce Development: Communication, teamwork, leadership, and emotional intelligence should be specifically addressed in training programs. These skills are crucial for collaboration and career advancement.
3. Encourage a Growth Mindset: The workforce must be prepared to embrace continuous learning. As new technologies emerge, professionals who are adaptable and willing to upskill will be best positioned for success.
4. Support Career Development Beyond Technical Training: Employers should provide opportunities for HI professionals to develop leadership and strategic-thinking skills through mentorship, cross-departmental projects, and professional development initiatives.
5. Recognize the Human Advantage: While technology will continue to play a transformative role in healthcare, it is ultimately the “human in the loop”--offering judgment, creativity, ethical decision-making, and interpersonal skills--that will continue to drive meaningful progress.

The evolving RCM landscape presents both challenges and opportunities for the HI profession. While automation and outsourcing are reshaping the industry, they are not eliminating the need for skilled professionals. Instead, they are reinforcing the importance of human skills that technology cannot replicate.

As AHIMA continues to support the professional development of HI experts, we must ensure that critical thinking, problem-solving, and soft skills are embedded in everything we develop, from certification programs to continuing education. By doing so, we can empower the workforce to not only adapt to change, but to lead the industry forward.

The future of health information is not just about understanding technology; it’s about leveraging the human advantage. And that is a future worth preparing for.

Jennifer Mueller, MBA, RHIA, SHIMSS, FACHE, FAHIMA, FACHDM, is Senior Vice President of Health Information Career Advancement at AHIMA.