How Top Healthcare Teams Tackle Provider Payments — and Win 

The payment problem: Why efficiency matters

Healthcare organizations face a perfect storm: manual workflows, paper-based processes and error-prone tasks slow down payments and increase denials. Every denied claim means wasted time, lost revenue and more rework. For provider organizations, the challenge is clear: streamline payment operations or risk falling behind.

What high-performing teams do differently

It starts with a mindset: high-performing teams treat payment operations as a strategic advantage, not just a back-office necessity.

• Clear goals and KPIs: Successful teams set measurable goals and track progress publicly — using dashboards, whiteboards or even simple PowerPoints. Everyone knows what’s expected and how they’re performing.

• Automation first: By automating tedious, error-prone tasks like payment posting and prior authorization, teams reduce lag and boost efficiency. Automation isn’t just a tech upgrade — it’s a strategic investment in healthcare payments automation.

• Data-driven decisions: Visibility into payer trends and denial rates helps teams spot issues early and focus improvement efforts where they matter most.

• Modern electronic workflows: Moving away from paper and manual processes reduces friction, errors, and costly rework.

Reducing denials: From cleanup to prevention

Denials are more than just a nuisance — they’re a costly drain on resources and morale. For many provider organizations, denial management is a reactive process, focused on cleaning up after the fact. But leading teams flip the script, approaching denials as a strategic challenge to be solved proactively. They understand that every denied claim is a signal — a chance to uncover root causes, spot trends and prevent future issues.

Here’s how they do it:

• Spotting trends early: Using data, teams identify payer-specific issues and systemic problems before they escalate.

• Prevention over correction: Improving front-end accuracy—like eligibility checks and coding—minimizes downstream denials.

• Prioritizing automation: Auditing manual processes (think paper remits or faxes) and automating wherever possible is key.

Building a high-performance team culture

Behind every successful payment operation is a team that feels empowered, engaged and invested in the mission. Culture isn’t just a “nice to have” — it’s the engine that drives innovation, resilience and sustained performance. High-performing teams know that clear goals and KPIs are just the beginning.

These teams set the standard for what’s possible in provider payment operations by emphasizing:

• Measurement and recognition: Track the impact of process changes and celebrate wins, like improved first-pass resolution or reduced rework.

• Training for problem-solving: Teams learn to recognize and solve recurring issues, not just react to them.

• Ownership and collaboration: Cross-functional teamwork and continuous improvement drive results.

• Celebrating achievements: When leaders can show the financial impact of their teams, securing investment in automation and resources becomes much easier.

The bottom line: Efficiency drives performance

High-performing healthcare teams don’t just work harder — they work smarter. By embracing healthcare payment automation, leveraging data and building a culture of ownership, providers can reduce denials, accelerate payments and improve financial outcomes with a robust healthcare payment platform.

Ready to see these strategies in action?

Watch our expert video above with Stephanie Brookings, senior director of provider enablement, and discover how Zelis empowers provider teams to tackle payments and win. If you’re ready to put the payer-provider relationship at the center of payment operations — and get better outcomes on both sides — we’re ready to help.