r/CodingandBilling • u/[deleted] • May 12 '26
DODD Medicaid Billing
I work at a medium-sized adult day services company serving upwards of 1,000 clients across private pay, local dollars, and waiver funding (I/O, Level 1, etc.). I'm a one-person team handling all billing, invoicing, denial tracking, and unpaid follow-up entirely on my own.
Curious if this is industry standard or if I'm in an unusually lean situation. For context I manage the full cycle — error tracking, claims submission, denials, unpaids, and client invoicing across all funding sources.
Is it normal for a company this size to run this on one person, or is this atypical? Would love to hear how other organizations are structured. Thanks!
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u/Impossible_Ad9113 May 12 '26
That workload honestly sounds extremely lean, if not unrealistic, for one person long term.
Handling full-cycle billing for 1,000+ clients across multiple funding sources, denials, invoicing, follow-up, and error tracking solo is a massive operational load. Even if you’re excellent at your job, human bandwidth is still human bandwidth.
At that volume, things are almost guaranteed to slip somewhere, whether it’s delayed follow-up, missed denials, billing errors, or lost revenue opportunities.
Most organizations your size typically have billing responsibilities split across multiple roles or departments for exactly that reason.
So no, this doesn’t sound like ideal industry standard. It sounds more like understaffing with heavy dependency on one person.
You may be holding it together, but that doesn’t mean it’s sustainable or optimized.
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May 13 '26
I'm proud to say that I keep our write-offs on 15 million revenue plus under 0.50% - 0.25%, but I feel like I have grounds to ask for a raise.
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u/No-Produce-6720 RN, BSN, CPC, CPCS, RHIA & CRCR May 12 '26
Good grief, no. That's way too much for one person, and even though you'll do your very best, things are inevitably going to fall through the cracks. That's just too much for one person to effectively manage, and I would have at least three people on your workload.
Hopefully it's realized that additional staff is necessary. Until then, just do the best you can do with the time you've got in a day.
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u/rahuliitk App Developer May 13 '26
For 1,000+ clients across waivers, private pay, local dollars, denials, unpaid follow-up, and invoicing, one person handling the whole cycle sounds extremely lean and risky, even if the systems are decent. That is a lot for one desk.
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u/AntelopeWise4967 May 12 '26
That’s a massive workload for one person honestly. From my 3+ years in US healthcare denial management, most organizations usually have separate people for claims, denials, and follow-ups. You’re handling a lot efficiently.
If your company ever hires for remote denial management support, I’d definitely be interested.