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How do I go about telling my manager I refuse to take on additional work without being compensated accordingly?

I work in an oncology office within a hospital as a reimbursement specialist in the state of California. I have worked there for two years but have a total of 5 years of experience. Long story short, the hospital is not doing well financially. We are understaffed but can’t afford to hire additional staff. Insurance laws changed this year for Medicaid plans and my workload has tripled within the last 6 months. I’ve expressed to by employers that I am burnt out, depressed, and they are aware that I have a chronic autoimmune illness that is exasperated by stress. One of our two medical assistants has found employment in another department, leaving us with one doctor, one secretary, one RN, one MA and myself for a clinic that sees on average of 15-18 patients a day. Rather than hire additional help, my management has decided that her work will be…


I work in an oncology office within a hospital as a reimbursement specialist in the state of California. I have worked there for two years but have a total of 5 years of experience.

Long story short, the hospital is not doing well financially. We are understaffed but can’t afford to hire additional staff. Insurance laws changed this year for Medicaid plans and my workload has tripled within the last 6 months. I’ve expressed to by employers that I am burnt out, depressed, and they are aware that I have a chronic autoimmune illness that is exasperated by stress.

One of our two medical assistants has found employment in another department, leaving us with one doctor, one secretary, one RN, one MA and myself for a clinic that sees on average of 15-18 patients a day.

Rather than hire additional help, my management has decided that her work will be dispersed among the remaining staff. We were also notified that we should not be expecting raises this year, adding to already low employee morale.

In my state, the average salary for my position is $55,500 a year and I’m currently making $44,000. Mind you, that’s not even taking the current inflation rate into account.

My job is not in a position to fire me, but I also don’t have many options within another medical facility since the nearest other hospital is over 100 miles away (I live super rurally.)

I need my health insurance to pay for an upcoming surgery I’m having so looking for something remote or alternative employment is in the cards for the future but not right now.

So going back to my question

How do I go about telling my manager I refuse to take on additional work without being compensated accordingly?

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