Jenny is an RCM specialist in the healthcare industry with extensive experience in numerous aspects such as process improvement, strategic planning, revenue cycle management, and research and analytics, among others.

Her expertise includes finding ways to cut costs, save money, and reduce redundancies to increase output, lower AR days, and improve overall efficiency. In this interview, Jenny talks to me about her remarkable achievements in the field and her business learnings that have helped her align every area of an organization to ensure positive outcomes to sustain long-term growth.

Starting in the RCM Domain

Ever since she was a child, Jenny was attracted to the healthcare industry and initially wanted to be a surgeon. In college, Jenny got married and started her family after which she shifted focus to the business side of this domain. She began working at an internal medicine clinic where she would answer the phones, schedule appointments, handle pre-authorization, and eligibility.

Over her career, Jenny has managed a few various specialty clinics, ran a business office of a Critical Access Hospital, implemented healthcare software during meaningful use, managed a central billing office (CBO) for various large multi-specialty physician groups across the country, and ran a revenue cycle team on the Eastern region of the US. Now she is responsible for running a National RCM team that is in all four time zones.

‘I am very operationally minded and result-driven, so I love to look at things and figure out how we can streamline, make process improvements and then eliminate the need for the unnecessary touches and then from there see what can be automated.’

Within healthcare, Jenny has worked in various fields. From working with multi-specialties and anesthesia she made the transition to behavioral health and psychiatry.  Talking about the difference in RCM cycles across these fields, Jenny states that every specialty varies a little bit. For her, anesthesia proved to be the most complex owing to the complexities of billing.  The billing in behavioral health is much simpler from a billing perspective

‘RCM is so complex and there are so many nuances.  I think the most exciting stage in the RCM is the satisfaction of the patient.  Our goal is one-touch resolution, meaning we want to ensure we answer all your questions the first time you call.  While it’s definitely not an easy job, our patient account representatives lead with compassion and empathy.’

Current Business Structure and Organization

Jenny currently works for a behavioral health company, Community Psychiatry, involved in completing end-to-end revenue cycle collections for the company.  They take care of everything from registration, eligibility, data entry, charge entry, scrubbing of the claims for errors, claim submission, payment posting, denial management and resolution, and contract compliance.

At present, the company is internal, and not a vendor or an external billing company.  They have a group made of social workers, mid-levels, psychologists, and psychiatrists. They offer therapy services, med management services, and a few other service lines like TMS and Spravato.

The organization has over 70 locations in California, North Carolina, South Carolina, Florida, and Texas. Jenny has a team of about 130 people across the country and recently engaged an offshore company to assist with several RCM projects. Her current focus is on trying to balance the process improvements to improve sustainability while adding to the team due to the growth.

Standout Moments As a Business Leader in the Domain of RCM

Jenny recalls a few years ago when they were working on automation, the RCM team had been divided into groups where they created their own Bot. Some were made of blocks, others were made of various household items, while others went all out and created mini-robots that would run around the office.  On the day of go-live for the robotic processes, the teams had the office decorated with the various robots and the electronic robots running around the office.  For Jenny, this was an unforgettable team experience and a huge moment of pride in her team.

‘While the work required to get the robotic process automation in place was not easy, I couldn’t be prouder to be part of the team that accomplished it.  I will never forget the team experience.’ 

Talking about a standout moment from the organization’s point of view, Jenny states that healthcare is complex and on the billing side people don’t always realize the complexities.  Things can change on a quarterly basis, from a payer perspective, and they can change any day of the month from a contract perspective.

For subject matter experts, it is important to be able to pivot very quickly to respond to the needs of the business. During the Covid-19 pandemic, Jenny recalls going from using the analog fax machine, paper processes, and having to work in an office setting to being able to completely work remotely in 72 hours which was pretty remarkable.

‘The decision was made Friday afternoon and by Monday morning we had 98% of our users connected and working remotely. In an industry that was not commonly remote, the pandemic has changed the minds of many and allowed us to focus on true metrics and the relative results.’

Overcoming Challenges in Business

One of the challenges Jenny has faced in business is getting people to embrace technology in healthcare, but also realizing not everything can be automated.  She believes that no matter what can be automated in the life cycle of a claim, there is always going to be a strong need for critical thinking and problem-solving. The company has come up with incentives and things from a cultural perspective that Jenny believes outperforms automaton significantly.

Business Plans for Improving the RCM Functions in the Future

For Jenny, a priority is streamlining the RCM processes and utilizing technology wherever possible.  She believes that anytime technology can be utilized, the company can eliminate the constant increase of labor needs. The use of technology can also improve the quality outcomes of sending out a clean claim and getting paid the first time.  One visit/claim could be touched 7 or 8 times through the life cycle of a claim.  When there are so many touches, user error can definitely be a factor.

‘My goal is to streamline processes, eliminate any unnecessary or duplicative touches, and utilize technology where we can.’

Top Philosophies and Core Values in Business

Jenny’s goal as a leader is to create the best place to work while also delivering the best in the industry results. This culture creates loyalty, trust, puts integrity above all else, and consistently collaborates to identify and resolve issues. This culture is made up of people who are never complacent and are always striving to do better.  When this culture is created, the team is unstoppable.

‘I think if you take care of people, they naturally will take care of your stakeholders/business.  Culture is everything.’

As a leader in the field of RCM, Jenny defines the implementation of clear, defined roles and responsibilities of every team member as one of the best practices she has implemented in her process over the years.

Advice for Newcomers Starting a Career in the Field of RCM

Jenny advises starting on the front lines in a clinic or hospital.  Begin with answering those phones, scheduling patients, and always striving for excellence. A lot of character development comes from standing on the front lines. She believes that it is hard to get the end-to-end understanding in a big organization like a central billing office if one starts on the backend as it makes them blind to the patient experience.

Another thing is to really find what area of RCM one is most passionate about by trying various areas.  The lifecycle of a claim has many roles. People have to figure out what they like, whether that is the interaction with the patients on the front end or intake, whether it is understanding the benefits of being able to communicate those back from a registration standpoint, denial management, or more numbers driven.

Two Key Learnings Over the Years

1. Never forget to stop and celebrate even the small successes with your team or company.
2. Don’t forget to always give grace.

Vision for the Future of the Industry

Jenny believes constant improvement is needed until it runs like a well-oiled machine. Her company’s metrics today are exceptional, but they are always looking for further improvements.

‘We have a 2-3% denial rate and our AR days are 19 days currently, which is a huge success.’

For companies and professionals looking to remain successful in this domain, Jenny says it is important not to give up and remember that in an instant gratification culture, healthcare is not an immediate gratification fix.

In RCM, the claim is filed, and then two weeks later an EOB comes back where it reveals whether the claim has been paid or denied and requires follow-up to obtain resolution. It is difficult to know if the things being done are making an impact in a positive direction.  The diligence of research into resolution and being willing to pivot as needed is highly valuable.

Another thing Jenny advises is to keep the goal proactive versus reactive.  Any denial that can be eliminated from putting an edit on the front end or fixing the system to get a clean claim is extremely important.

‘Don’t give up because the feeling of seeing that well-oiled machine is most rewarding.’

Leadership Lessons Learned Over the Course of Life

Leadership is hard and people spend more time at work than they do a lot of times with their family. Jenny says that she always tries to make it fun. Even if they are problem-solving a big issue, her goal is to enjoy it and make it enjoyable. If people can make the work enjoyable and bring light to the people around, it is not really work and that is where the passion comes in.

‘Leadership is difficult.  You are dealing with various personalities, you are dealing with whatever storms they are going through and so a lot of times it is listening to understand what they are going through. Empathy and compassion are extremely important in leading a team.’

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