Uniquely Qualifed

I was on an interview for a senior revenue cycle director opportunity last week when the person on the other end of the phone said to me “…We are looking for someone uniquely qualified for this position…”


As soon as she said that I laughed a little. I knew what was coming next.


I asked what did she mean by the phrase “Uniquely Qualified”?


Her response was they wanted someone that had a wider knowledge of the revenue cycle; more understanding of their patient centric focus; a better grasp of how their revenue cycle is experienced from the patient’s perspective and then a few more buzz word phrases.  She finished the sentence with a comment that my résumé didn't reflect their current patient focus.


I replied, do you actually want a response, or have you made your mind up based on the few seconds you spent looking at the two pages that represent my life and experience to you?


She made that obligatory comment about “…if another opportunity arises…”, and that was that.


I pondered her statement for a moment and wrote out my response because I thought it was funny how they didn't want to know anything outside of the words on my résumé.  A trend I have found is more prevalent in the hiring process than in the past.


I've worked in healthcare for 20 plus years on the business office side of things in a variety of capacities.  I know what I know and I know what I don't know.  I think that last sentence is essential to meeting any true measure of being Uniquely Qualified.


I excel in how to locate, triage and solve pretty much any business office problem you have.  I don't want to say I've seen them all, but I don't think I would be surprised by anything at this point.


This is not because I am overly educated, it is because I have experience dealing with numerous iterations of chaos from one of 25 or more different business offices I have worked in, or the 150 clinics / doctors offices, or the 40 different medical collection agencies, billing companies, off-shore / outsource providers, vendors, lenders, ambulance companies, radiologists or assorted others directly related to revenue cycle flow.  I have even used the correct cover sheet on the TPS reports on more than one occasion.


I have worked on so many different health care systems I can't name all of them anymore. However, being uniquely qualified wasn't about the system knowledge I have or being able to look up patient data.


The fact of the matter is I've seen a lot of problems, challenges, issues, solutions or whatever you call them.  I have also seen some incredible success stories and truly awesome leaders, people and processes that are a vision of beauty and models of efficiency.  I've met and worked with people from all over the country and for that matter several other countries.


I have found solutions where they previously weren't known, solved or even looked at enough to do more than bandaid over them to survive another day.  I have learned new and fantastic techniques and acquired skills beyond my wildest dreams and expectations and I have so many people to thank for giving me the opportunity to do so.


And I don't consider myself even close to being an expert; make no mistake about that belief.


Let's also grasp a very important concept related to my experience:


“Change is constant and inevitable, the willful application of time, energy or resources to deny or delay the nature of entropy is abjectly futile”


Accepting this concept is a pre-requisite for long term growth and success, in my opinion.


I've run across many healthcare leaders that only accept the illusion of change, as long as the status quo is maintained and their revenue cycle continues in a predictable and artificially controlled way.  Which usually means they are driving the Titanic into the iceberg, but with a smile and some great slogans and hope they move on before it hits the ice.


What I have that a lot of people in the business office world don't have is a great deal of experience with how an actual patient flows through their revenue cycle. 


What I have is experience helping people understand their medical bills, how the admitting process works, how registration fits into billing and how insurance (government and commercial) pays or doesn't pay for services; how medical records flow, or how to appeal a denial because you mother doesn't understand the pre-authorization process and why would she at 80 years old.


Think of it like this, if you don't know how to fix your computer you call some IT person, friend or family member.  For me, I get calls from friends, family, my ex-wife's family, people I've worked with or people I run across in airports that don't understand how the revenue cycle works for them.  And every single time I have been asked I stop and explain it the best I can.


Why you ask, because it's a confusing process for most people.  And it's the right thing to do. That's why.


There is a great deal of talk about the patient experience, or making patient billing more friendly and lots of talk on the internet and at various health care conferences about patients in the revenue cycle; but always at the 40,000 foot level like it's a concept or theory and not actual people.


For a moment, ask yourself how many times have you actually experienced side by side someone going through the care process and you could explain how it works and how it will impact them? 


A year ago I had to make a career vs. family decision.


My mom is older and she needed help.  She needed someone to take her to doctors and the hospitals she frequents and help with her understanding of the continuum of care.  So I dropped my primary focus and began to help her. 


I know this alone doesn't make me special or entitled to a given thing, but it was what the person doing the interview claimed they needed, but appears they didn't want it that bad.


I have been to inpatient hospitals, out-patient clinics, doctors offices, specialists, emergency rooms, chemo therapy centers, infusion services, labs and so many other places I stopped counting them. 


I've seen how registration and admitting works at some great places and how it works in some not so great places.  I've seen excellent examples of patient billing and truly abysmal examples of patient billing. 


I've explained to the registration staff how to navigate their own screens to ensure billing is identified so it is done correctly. I've translated patient friendly notices and the various pieces of paperwork into a language that an older person can understand.  Because patient friendly doesn't always mean what you think it does.


In short, I've spent 500 hours living the patient experience in the past year.


What this makes me is simply more rounded in understanding the process and the revenue cycle from the patients point of view.


It makes me more empathetic towards the patient.  It means I actually know what the patient experience is, I didn't read about it on a power point presentation.


And in the revenue cycle, we need more of that.


On this same interview I was asked if I knew some extremely minute detail about a state specific Medicaid system coding sequence.  I said I didn't know the detail they asked, but I know how to get the answer and I know how to solve the problem.  The question was so extremely specific that I was kind of surprised they brought it up.  It was akin to asking the pilot of a commercial aircraft what is the part number of an eighth stage compressor blade of the PW100-6 Bombardier Q400.  Next time I fly on Alaska Air, I think I will ask the pilot if they know that answer…


I derive a lot of pride in what I know and what I don't know and how I obtained this knowledge.


I wouldn't change any of what has amounted to my learning so much about the revenue cycle and honestly how a patient navigates this convoluted process.


So to answer her question, I in fact think I am uniquely qualified for what you need but perhaps, not what you want, because you haven't taken an honest look at that anymore than you likely do with most candidates that you interview.