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In2itive Business Solutions, Revenue Cycle Team Serial Blog Posts

31 Aug 2015, Posted by Nila Dowel in Billing, Healthcare, Revenue Management

 

In2itive’s “How To Be a Rockstar” series takes a look at the individual roles that make up an amazing business office and revenue cycle management team. Learn from our own rockstar leaders what makes each role essential, how we measure each role’s success and what tasks and obstacles come with the territory.

Meet Nila Dowell: Revenue Cycle Manager & Billing Specialist

First and foremost, it’s up to me to make sure the money is coming into our center, and if that money is not coming in, I have to find out why. In that way I’m kind of the cleanup specialists.

There are a lot of little nuances to this role, and it requires very broad knowledge of payor contracts, bundling arrangements, codes, verification requirements—the list just goes on. But without that base knowledge, you can’t catch important errors. And if I don’t catch those errors, I could be responsible for my center leaving anywhere from $500 to $10,000 or more on the table.

My Territory: The Tasks & Obstacles

The tasks involved in my role are unique, because I’m a revenue cycle manager (RCM) but also a biller. So billing always gets done first, no matter what. From there, it’s all about managing the unique situations that arise in the day-to-day, which is when broad base knowledge becomes important. I suppose most of what I do can be distilled down to information gathering, verification and coordination, all in effort to get our claims out quickly and correctly the first time.

If I do my job well as an RCM, then everyone else’s job should go more smoothly. I know what questions to ask (and who to ask!), I know what forms and attachments are required for a given claim, and I know the nature of our payor contracts, which means I know how we should be paid. So at any given time, I am fully aware of what payments we’re expecting, which means I can flag a situation if we’re not being paid appropriately.

The Ticket to Success in My Role

Being an RCM requires that you be a multi-tasker. I live and die by cheat sheets—I keep them for everything! That also means that anyone considering this role needs to be able to keep their head about them; there will always be more to do than can actually get done at once, so you have to be able to breath and not let yourself get overwhelmed.

Equally as important, my job requires that I never hesitate to ask lots of questions. And I can never be arrogant enough to assume I know the answer because of how frequently this industry changes. In conjunction with that, I have to maintain a positive relationship with my co-workers and centers, because we rely on each other to stay educated and accountable.

To go along with that, being an RCM requires logic and self-motivation. You have to be motivated enough to do your own research for every situation, and then you have to be able to reason your way through the solutions.

Contact Jocelyn Gaddie to discover how the rockstars at in2itive Business Solutions can help improve your facility’s monthly financial performance.

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