2025’s medical billing pain points: Insights and solutions for billers

The medical billing landscape continues to evolve, and professionals now face a range of medical billing challenges 2025 brings that put operational success and revenue collection at risk.

Tebra’s recent survey of medical billing professionals sheds light on the industry’s most pressing pain points. Facing rising denial rates, workforce challenges, and financial constraints limiting technology adoption, medical billers must be proactive to maintain stability and growth. 

This article explores the biggest challenges medical billers are facing in 2025 and the strategies to overcome them.

Claim denials continue to be a growing concern for medical billing professionals. According to Tebra's survey, 40% of billers reported an increase in denials over the past year. The top reasons for these denials include:

Denied claims significantly impact revenue, with nearly 50% never getting reprocessed. Writing off even one denied claim per week can lead to thousands of dollars loss from a biller's net revenue. When denials become frequent, medical billing companies lose money through increased administrative costs associated with claims resubmissions and appeals. 

Beyond financial losses, frequent denials create operational inefficiencies. These can increase staff stress and strain relationships with medical practice clients due to delayed claims processing.

Here are practical ways to reduce denials and manage them better when they do happen:

You can also use a simple exercise to calculate the financial impact of denials on your organization over one month.

To start, gather your data:

Once you have the data, use the following formulas to calculate how much denials cost per month:

To account for cash flow delays:

For in-depth support around stopping denials in their tracks, check out our comprehensive denials management playbook.

Tebra's survey revealed that demand for skilled medical billing professionals is outpacing supply. Thirty-eight percent of billers say they struggle to find qualified candidates, while 28% point to rising wages they can’t afford as a major issue. Many medical billers are also facing burnout — largely due to a lack of career growth opportunities, repetitive tasks, and inadequate training — which can fuel frequent turnover.

The solution? Building a better work environment that tackles these workforce challenges head on. Here are solutions to consider:

It may be difficult to fully get ahead of rising wages, but offering targeted incentives like performance-based bonuses and employee well-being programs can boost staff satisfaction without drastically increasing your payroll expenses.

Offering hybrid or remote work can attract new hires, reduce burnout, and help you keep the staff you already have. Nearly 48% of respondents in our survey reported that they have implemented remote work arrangements for these purposes. 

More than half of the Tebra survey respondents reported that their teams spend 51–75% of their time on repetitive administrative tasks like payment posting, insurance verification, claim submission, and claim status updates. Using AI and automation tools, such as RPA, reduces administrative burdens, allowing billers to focus on high-value tasks, increasing professional satisfaction and reducing the chances of burnout. 

Professional development opportunities can make billing positions more appealing at your company and help retain top talent. Consider the following:

Implementing structured feedback mechanisms fosters a positive work culture, making employees feel valued and reducing turnover rates.

As mentioned above, technology can make revenue cycle management (RCM) more efficient by automating repetitive tasks such as claim submissions, insurance verification, and payment posting. Implementing automation, such as RPA, boosts productivity, reduces burnout, and frees staff to focus on high-value tasks — delivering long-term financial and operational benefits.

But despite growing awareness of automation’s benefits, 57% of the billing organizations Tebra surveyed have delayed technology investments due to budget constraints. Moreover, 42% of them have yet to adopt automation for billing tasks — despite 48% being optimistic about AI's potential benefits for RCM. This gap between awareness and adoption could be because of barriers like perceived complexity, high upfront costs, or uncertainty about return on investment (ROI).

Here are cost-effective ways to ensure your billing operations can benefit from the ever-advancing technology landscape:

Navigating the medical billing challenges that 2025 brings requires a proactive approach. By streamlining denial management, improving recruitment and retention strategies, investing in continuous training, leveraging automation, and enhancing patient billing strategies, medical billers can drive efficiency and secure long-term success in the industry.

For more strategies on how to manage denials more successfully, check out our denials management playbook. It offers step-by-step guidance on reducing denials, streamlining resolution workflows, and recovering lost revenue. Stay ahead in the billing industry by adopting proactive strategies today.