Hiring and Firing
the “Scoop on Office Employment”
New Employee Hiring
 Start with FIRST things FIRST- What does the Practice really
need here?
Evaluate the Practice to determine if the position is truly a
necessity, or would restructuring your office resolve
the issue.
*Sometimes offices expand too rapidly eating up valuable
working capital that provides job security for all.
*The quality employee would prefer to learn new tasks and be
more productive for greater pay.
Define the Position
 Job Description
An organized, well functioning office is one that has clearly
defined the tasks and expectations of each position.
Create a job description for the new position, or review
the existing one to make sure all the needs you are seeking to
cover are contained in the description.
Quick Basics on the Legalities of Hiring
 the hiring process should be free of any indication that the
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hiring decision will be based in any way upon race, color,
religion, gender, national origin, age, or disability.
you only have to take applications if you have vacancies.
base hiring decisions only on job-related criteria.
be consistent and judge applicants on qualifications, not
assumptions or stereotypes.
verify references, employment history, and background
information and document your efforts.
Placing Your Ad
 Use your written job description to create the advertisement for your
position.
 Be accurate in your description of what the position requires. Use
positive, upbeat language to describe the position and work
environment.
 Cast a “wide net” when looking for new employees, especially for entry
level positions. Someone eager to learn with a great work ethic is often
the better choice over experience without those qualities.
 Consider posting the position with your local newspaper and the Texas
Workforce Commission. Candidates will be able to email applications,
resumes and cover letters.
Sample Job Advertisement
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Billing Trainer (Medical)
About the Job
Voted one of the BEST PLACES TO WORK by our employees for 6 years!
PURPOSE: Coordinates and conducts training activities to include development of curriculum and delivery of job specific training related to medical billing
and business office functions, as well as creating eLearning while managing overall process by utilizing a Learning Management System. Carries out all duties
while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.
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ESSENTIAL FUNCTIONS:
Develops course material according to the needs analysis and requests.
Coordinates class schedules, maintains and revises curriculum, and conducts business office and billing and collection training including registration,
appointments, check-in and insurance procedures, referrals, coding, etc.
Collaborates with departments to identify training needs and develops training documentation specific to medical Practice Management applications,
workflows, and/or departmental processes.
Participates in system upgrades through analysis, testing and development of documentation to support workflows and procedures.
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OTHER DUTIES AND RESPONSIBILITIES:
Assists the Staff Development Manager and team members with identifying other training needs, developing training materials, and conducting training.
Attends meetings, participates in workgroups and/or serves on committees as needed.
Performs other duties as assigned.
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MINIMUM QUALIFICATIONS:
Education: High school diploma or equivalent. Bachelor’s degree or an equivalent combination of education and/or experience required.
Experience: At least 2 years of experience in an administrative role within a medical setting. Experience utilizing LMS and creating elearning materials
preferred. Experience working with a Practice Management System preferred.
Job Application Office Application for Employment – You don’t have to use
one and it doesn’t have to be complicated or long. But if you
do, make sure that office’s application for employment is free
of any questions that could convey discrimination such as age,
national origin, gender etc.
 Sample job application for a position with the State of Texas
http://www.twc.state.tx.us/jobs/gvjb/stateapp.pdf
Reviewing Applications
 Have realistic expectations when reviewing applications.
Base expectations on the level of the position hiring for.
 Look for candidates who offered more than the required
information. Cover letter, resume, etc.
 Look at what was said and left unsaid. Gaps in work history,
number of employers, reason for leaving
Personality Check
 Before the first interview is set up, stop to evaluate your current
staff.
 There are 4 Basic Personality Types, each one has strengths and
weakness. Certain combinations clash more than others.
 Not taking personality into consideration when hiring a new
employee often means the difference between a date and a
marriage.
 This often means wasted time, money and effort are spent training
someone who will not stay on as a long term employee.
Or worse, they stay and ruin a cohesive team sometimes running
off the best help the practice has. Take this seriously!
 Take the time to figure out which personality will fit well with
your existing staff and compliment the position being filled.
Crash Course in Personalities
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4 Main Personality Types
Popular Sanguine - “life of the party” personality dresses for
attention, very social and upbeat, energized by people.
Driven Choleric- “Type A” personality, gets the job done, takes
charge, strong, dominate personality, energized by people.
Melancholy - “the mentalist” personality, thinks things through,
organizes, makes lists, artistic, need to withdraw to recharge.
Phlegmatic “laid back” personality, easy going, peaceful, nonchalant, unexcitable,
need to withdraw to recharge.
Positives and Negatives
 Sanguine – a “people” personality. They get along well with others
and are upbeat. They love interacting with others and play the role
of the entertainer in group interactions. But can be easily
distracted and not always reliable about getting work done. They
have a tendency to over-promise and under-deliver. Their lively
clothing and accessories can help you identify this personality
type.
Consider this personality for receptionist or nurse
 Choleric – also a “people” personality and are very driven by
accomplishing goals and tasks. Hard works but, but can run
rough-shod over others. Tend to be decisive and stubborn.
Consider (carefully) this personality for office manager, billing and
collections
Positives and Negatives
 Melancholy – “Creative – Artistic” personality type. Highly talented
they often have great ideas. Making lists and doing things the “right
way" are characteristics of this personality. Though they usually enjoy
people, they tend to need quiet spaces and time to withdraw and
recharge.
Consider this personality for office manager, billing and collections, getting
a new practice off the ground or taking established to a higher level.
 Phlegmatic - “Laid Back” personality type. Very neutral, they tend to
avoid conflict, but their indifference may frustrate co-workers. They hate
making decisions, and generally go for the status quo. They care about
people and harmony
Consider this personality carefully before bringing them on board.
Phlegmatics can have poor work ethic but the right one can be a quiet work
horse.
Group Dynamics Consider the existing group dynamics of your office staff. Do your
best to select the candidate whose personality is a good job match,
but also compatible with the personality types they will work
closely with. For example;
A Choleric office manager might be frustrated with a Phlegmatic
billing person who doesn't seem to want to get things done as
quickly as they would like. This pairing can work well however,
because Cholerics tend to tell people what to do, and Phlegmatics
tend to do what they are told.
Melancholies who make lists and work through them point by point,
can be frustrated by Sanguines who tend to bounce from one task
to the next, often without completing any of them.
Preparing to Interview
 Before the interview process begins, prepare yourself . Know the
qualities and personality type you are seeking.
 Plan to ask at least one or two open-ended questions to gain insight into
your candidate. “Tell me about your work experience”, “What are you
seeking from your employment”
 Review the resume just before speaking with your candidate and make
notes on the resume for later reference if needed in the decision making
process.
 Look for a pleasing attitude and willingness to work, demeanor can be
more important than skills.
 Gauge personality type – sanguines and cholerics are easy to spot,
melancholies will reveal themselves during the interview and if you can’t
tell, they are probably phlegmatic. Take note of this as well .
Selecting the Best Candidate
Having interviewed your candidates it’s time to move on to the decision.
Sometimes you get everything you’re looking for; well qualified, winning
attitude and personality, professional. Sometimes you don’t.
In most cases, the candidate with a positive attitude, strong
work ethic and needing the job will turn out to be the better
long term fit over the person with flawless skills, poor attitude and
work ethic. Perhaps they don’t even need a job.
Choosing hungry over qualified almost always pays off. Gratitude, and
winning attitude in someone eager to learn usually yields long term success
for everyone.
Making the Offer
Now that you have found your potential new employee, it’s
time to make your offer.
 Be clear about salary, benefits, vacation and sick days.
Consider a written contract.
 As the employer, follow through on your end. Keep your
word.
If your offer isn’t accepted but you really want this person,
consider benefits such as additional time off (half afternoon),
flexible hours and other perks that don’t have to cost money.
The New Employee
Texas laws requires employers to get I-9 information on all new
hires within 3 business days of hiring.
Texas Law does not require an Employee Handbook. However, creating one is well
worth the time and effort. It can help protect against costly and damaging
lawsuits.
 Addressing work attendance, vacation/time off policies and harassment issues
will provide clear expectations; helping new employees understand the work
environment and ethics of your practice.
The Texas Workforce Commission has sample forms and policies.
 http://www.twc.state.tx.us/news/efte/table_of_contents-az.html#aztocappendix
Training and Acclimation
 Now that you’re hired your new employee - set them up to succeed!
 Use the job description to make sure they are appropriately trained and
informed on how to do their tasks. If there are deadlines, repeating
tasks, be sure to address this.
 After they are up and going, cross train them for other positions in the
office. Particularly those they work closest with. (billing person with
receptionist, nurse with office manager). This gives everyone insight
into what their co-workers do and your practice needs to function
smoothly.
 Staff meetings. Have a weekly or monthly staff meeting to address issues
as they come up and praise employees for their work efforts.
 Formal Review; have a quarterly or annual employment review,
compliment and reword effort, address problems timely.
It’s Not Going Well…
 How do we handle employees who are not performing well?
 COMMUNICATE! Often, when needed and early.
 Regular staff meetings allow issues to be discussed as they arise, in broad, general terms.
If this does not resolve the issue;
 Performance Reviews. When instituted as part of your business management style, these
go the distance in addressing and resolving problems. Most employees need their job,
some just need to be reminded that performance and job security are synonymous.
Refer to job description and be clear about what the problem is.
 Write Up. If meetings and performance reviews to do turn around a chronic poor
performing employee, write them up. Schedule a private meeting, address the problem
clearly and have them sign an acknowledgement agreement that documents the
conversation.
 Reduce Hours. If the problem persists, reduce work hours. Texas is a hire and fire at
will state. Documentation showing due diligence to correct the problem is only a bonus.
Most people need income and this step typically pushes a poor performed out the door.
It’s the Law – in Texas
http://www.twc.state.tx.us/news/efte/pay_and_policies_general.html
Pay and Policies – General
The basic rule of Texas employment law is employment at will, which
applies to all phases of the employment relationship - it means that
absent a statute or an express agreement (such as an employment
contract) to the contrary, either party in an employment relationship
may modify any of the terms or conditions of employment, or
terminate the relationship altogether, for any reason, or no particular
reason at all, with or without advance notice
It’s the Law – in Texas
Exceptions: Other than statutes and express agreements, the
only significant exception to employment at will is the "public
policy" exception, i.e., no termination or adverse job action
against an employee in retaliation for the employee having
refused to commit a criminal act on the employer's behalf
thus, in an employment at will state, and to a lesser extent in other
states, employers may develop and change personnel policies,
reassign employees, and change such things as work locations,
schedules, job titles, job descriptions, pay, and other aspects of jobs
at will.
Team Building – Summary
Every successful business is built on a variety of factors. However,
quality staff that are well trained, work as a team and place a high
value on relationships will, to a large extent, determine the
success of your practice.
Considering personality types goes a long towards building a team.
Cross – training brings a level of co-worker awareness that few other
efforts can touch.
Weekly/Monthly staff meetings build awareness of the necessity of
working together as a team.
Employment reviews with performance incentives (pay raise,
vacation/personal days) keeps effort and moral high.