2003 Salary Survey Results

Latest hiring trend adds medical records experience to access mix

Hospital requirements more demanding, but salaries not always in line

It’s been clear for a while that patient access managers could increase their marketability by beefing up their business office and patient accounting experience. But the very latest trend appears to be toward hiring a triple threat — someone who also has a background in medical records.

A bachelor’s degree in health information management, along with certification in the field, can help push an access manager’s salary prospects into the six figures, depending on geographical location, says Gina Seewald, executive recruiter for Atlanta-based Lillian Klock & Associates. "There seems to be a trend starting where it’s desirable [to hire] someone who has a background in medical records as a director, to oversee not only medical records, but patient access and the business office, she adds. "Six figures is very possible, but salaries are influenced by geographic location."

In less urban, low-paying areas, the salary for a person with those credentials might be $70,000, Seewald estimates, while in an area "where demographics and lifestyle [costs] are higher, you’re looking at a range of $110,000 to $120,000."

Another trend she has noticed is that hospitals are giving more weight to academic degrees. While in the past, 10 years of experience might have gotten the job, now it is more likely to be two years of experience with a degree. Depth of knowledge regarding various kinds of patient access software is "very valuable," Seewald adds. While the medical records piece still is a small blip on the radar screen for access director positions, she indicates, there is no question that "there are definitely more opportunities and it’s more desirable to have a business office background."

Gaining respect

As has been the case for several years, Seewald says, the field of access services continues to gain more respect. "Finally, it’s recognized that what happens on the front end really affects the back end. There seems to be even more focus on quality assurance, streamlining, and making sure the business office and the access office are hand in glove, that there is a meeting of the minds."

Scott Johnson, senior vice president and partner in J&J Resources, a health care placement firm based in Houston, agrees that hospitals and health systems are increasingly aware of the contribution a good access director can make to an organization’s financial well being. But he says, in many cases, the salaries being offered aren’t matching the qualifications being sought.

"There have been numerous jobs for patient access directors I’ve tried to fill, but what I’m seeing is a lot of hospitals don’t want to pay what it’s going to take," Johnson says. "That’s what is discouraging about it. You’d think an individual who has shown what they’ve done, how they’ve saved money, who can increase the bottom line, would be worth another $4,000 or $5,000 in salary. They can make that up in no time."

He says he recently placed someone in an access director position at a 355-bed hospital in the Carolinas, with a salary in the upper 60s. "She was coming from a salary that was about the same," Johnson recalls, "but it was a situation where she had to get out because of instability, which is why they got her for [that amount]." Just recently, he adds, he was trying to fill a regional access director position on the East Coast that would include oversight of four or five hospitals. "They wanted to top out at $70,000 or $80,000."

"I worked on the search," Johnson says, "but wasn’t able to get anybody for them. You’ve got people running [access departments] at 300- or 400-bed hospitals making that."

About 20% of his firm’s business involves patient access directors, Johnson says, and in recent months those positions have been more difficult to fill. "Money’s been an issue on just about every [placement]. [Hospitals] want the world — they’re really picky — but the salaries aren’t matching what they want."

Playing politics

"Salary politics" may play a role in hospitals’ reluctance to offer more equitable salaries for access professionals, he adds. "It’s the idea, If I pay this person that amount, I have to go around and give all the directors more money."

Adding to the difficulty in placing access directors, Johnson points out, is the fact that the field is dominated by women, who traditionally have been less willing to uproot family in order to make a move. That’s particularly true, of course, if the salary increase being offered is not significant, he notes. Still, there are hospitals that are willing to pay salaries that are in line with the skills they’re demanding, Johnson says. "We’ve got a hospital here in Texas with 800 beds or so that’s doing a search for a patient access director. They’re actually stepping up to the plate and are going to pay $90,000."

Salary breakdown

Most hospitals won’t pay recruiters to fill manager-level access positions, he notes. "They typically promote a supervisor from within unless it’s a huge organization. Even then, they’ve always got three or four supervisors eager to move up."

The biggest percentage of access professionals responding to Hospital Access Management’s annual salary survey — some 20% — reported having salaries of between $60,000 and $70,000, while just fewer than 18% are paid between $40,000 and $50,000. About 9% reported paychecks of between $100,000 and $130,000, while close to the same percentage said they make between $80,000 and $90,000, and a similar number, between $90,000 and $100,000.

The overwhelming majority of respondents — about 88% — got a pay raise in the past year, with most of those increases — 70% — falling in either the 1% to 3% or the 4% to 6% range. More than 95% said they work in a hospital, and most of those — 75% of the total — for a nonprofit organization. Thirty-one percent chose "director, access management," when asked to select their job title from a list, but another 33% selected "other" in that category.

Among the job titles written in by those respondents were director of admissions; director of patient financial services; director, business services; director, patient financial services and access; and director, revenue cycle. Most survey respondents — just fewer than 40% — live in the Midwest, while 25% live in the Northeast, and another 20% in the Southeast or the Southwest. The largest numbers were at opposite ends of the spectrum when it came to longevity in the field, with 22% reporting they had been in the access field between one and three years, and 15% saying they had worked in access more than 25 years.

As usual, female respondents far outnumbered their male counterparts, at about 85%. The largest percentage of those surveyed (28.6%) said they work between 41 and 50 hours a week, while a similar number (27.5%) put their hours at between 46 and 50.

For charts illustrating the 2003 salary survey results, click here.