How do you measure billing work before hiring?
Before changing dental staffing, ask your team to record billing work for five working days. Include corrections and exception handling. You need the time spent finishing the work, not just the time spent sending a claim.
| Record for each task | Example of what to count |
|---|---|
| Task and volume | Claims submitted, payments posted, or status checks completed |
| Active staff time | Minutes spent entering, checking, correcting, and following up |
| Unresolved work | Items waiting for records, payer answers, or a decision |
| Reason for manual work | Missing information, a matching problem, or a judgment call |
| Owner | The person who handles the exception and confirms completion |
For example, 60 status checks at an assumed four active minutes each take four hours. If a test tool reduces the first check to one minute each but leaves two hours of exception work, the new total is three hours. The observed saving is one hour, not three. These are fictional inputs; use your own task counts and measured time.
Test one repeatable task, then repeat the count with a comparable workload. Check accuracy and unfinished work alongside time. Keep decisions about disputed balances and unclear benefits with an assigned person. Use the billing scope worksheet to decide who keeps that work before changing a role.
Why is it so hard to hire dental staff right now?
Most staffing numbers you'll read are about hygienists. The ADA reports that only 60% of dentists have an adequate number of dental hygienists, and among those actively recruiting, 91% call it very or extremely challenging.
For the front office, the same analysis says the picture is less dire. So if you're hiring a biller, the problem isn't that nobody applies. It's that the people who apply don't have dental experience. That's a different problem, and it needs a different fix than a bigger job posting.
Raising pay doesn't fix it. The ADA found that after adjusting for inflation, average wages for dental office staff are down from a few years ago, while private sector wages rose. And there aren't fewer graduates. First-year hygiene enrollment rose 16% from 2020 to 2025, and 2025 produced the most graduates ever recorded. The ADA tracks the wider picture in its State of the U.S. Dental Economy updates.
So it isn't that nobody's out there. Pay fell in real terms while the work got harder, and experienced people left faster than new ones could learn.
The person you can hire now doesn't know dental
An RCM director running ten practices told us she used to hire people with dental experience and can't anymore. Candidates arrive from medical, vision, and orthopedics. Some have never seen a perio chart.
They're often good hires. They just need six to twelve months before they can look at an EOB and say it's wrong, and the practice absorbs that ramp.
The software doesn't help either. Practice management systems assume dental knowledge and were never built to teach it, so a new hire is learning payer rules, coding, and your system at once, from whoever is already busiest in the office.
What does automating billing actually save?
Here's the tradeoff at one group, in their own accounting.
Their model is one practice manager and two patient relation coordinators per location. Their RCM director's view is that if claims and attachments went out automatically, each office would need one practice manager and one coordinator. One position per location, freed by the two most mechanical workflows in the building.
That's not a vendor projection. That's an operator who audits ten offices describing her own model.
Cutting a role isn't the only way to win
Plenty of owners read that and think headcount. The hours come back either way. Keep both coordinators and you've handed the practice a full position's worth of time that used to go to claim entry and hold music.
That matters because billing work holds up other work. Here's where a practice gets stuck:
- Claims that don't go out same day sit in a queue, and every day they sit pushes payment further out.
- Verification that isn't done before the visit means the treatment conversation happens without real numbers, and cases stall.
- A front desk stuck on hold isn't answering the phone, and the calls it misses are new patients.
None of that shows up as a staffing problem. It shows up as slower cash, softer case acceptance, and holes in the schedule.
To size it: count the hours a week your team spends on claim entry, posting, and payer calls, then ask what those hours pointed at patients would be worth. For most practices that beats the salary.
What should a dental practice automate first?
Work that's repetitive, has a right answer, and teaches your team nothing.
| Automate first | Why |
|---|---|
| Claim submission and attachments | Mechanical, rule-driven, top cause of denials |
| Payment posting and reconciliation | High volume, exact answers, and hours nobody counts |
| Claim status and follow-up | Portal logins and hold music, no judgment involved |
| Eligibility verification | Automatable, with one caveat below |
Keep with a person: treatment plan presentation, the money conversation, and anything needing somebody to weigh a case rather than apply a rule.
One warning from the same operator. When that group centralized insurance verification, the offices lost the knowledge, and staff could no longer speak to insurance while presenting a treatment plan. Verification looks mechanical, but doing it is how a front desk learns what a plan covers. Take it away and you save hours while removing the only training your team was getting. So "automate everything" is wrong. Automate what teaches nothing, keep what teaches something.
Your team may be staffed against a problem that's gone
One more thing before you post the job.
A dentist told us the reason most practices skip pre-authorizations isn't the payers. It's that front-office staff say it takes too long, and dentists take that at face value. Meanwhile some payers now turn pre-auths around the next day.
Nobody's at fault. The staff saying it's slow learned billing when it was slow, and nothing in this industry tells people a thing changed. Payment posting went from most of a day each week to a few minutes when electronic remittance arrived, and large organizations were still doing parts of it by hand years later.
So it's worth asking, of everything your office calls slow: is that still true, or was it true in 2010?
Autumn takes the mechanical work off your team: claims and attachments, posting and reconciliation, and follow-up, while your people keep the patient conversations. Whether those hours become a smaller payroll or a fuller schedule is your call. If you want a read on how many hours are sitting in your workload, we do a free billing consultation. It doesn't take anything on your end.
How bad is the dental staffing shortage in 2026?
For hygienists it's severe: only 60% of dentists report adequate hygiene staffing, and 91% of those recruiting call it very or extremely challenging. For dental assistants and administrative staff the ADA says the picture is less dire. Wages across dental office roles are down after inflation, while private sector wages rose.
Will automating billing mean cutting staff?
Only if you want it to. The hours come back either way. Some practices reduce a position, others keep the team and redirect the time to treatment follow-up and answering the phone. Billing work holds up the rest of the schedule, so fixing it gets more done whether or not anyone's job changes.
What should a dental practice automate first?
Claim submission with attachments, payment posting, and claim status follow-up. Be more careful with eligibility verification, because doing it is how front-office staff learn what plans actually cover. Our comparison of billing models covers what each staffing approach costs.
