hen you work on the administrative side of health care, it’s harder to see the impact of your work on patients.
It can be easy to fall into the trap of thinking you are “just an enrollment specialist” or “just a MA”, but I’ve learned throughout my career that there is no such thing as “just” in any position of any organization. If your goal is to find ways to be impactful, you can make big changes in any role.
Here are three ways I’ve found impact in my job:
#1: Go and see how the work is done
I always wanted to work for University of Utah. My brother spent 60 days in the Burn Trauma Intensive Care Unit, and the way they cared for him stuck with me. It was such a rewarding experience. Right out of high school, I was hired onto Gail Draper’s team, doing billing and coding in the basement of Greenwood Health Center. The idea of working in a basement filling out paperwork all day might seem boring, but I loved every minute of it. I loved coding. I could go upstairs and watch providers, and see what codes looked like in real life.
Gail recommended that I join Rehab’s team as an auditor. Initially, I was sad to leave Greenwood, but then I realized that I was gaining an opportunity because I would be able to have direct interactions with the therapists. I could help make their billing work easier.
I remember watching a therapist help a patient struggling to use a salt shaker. In that moment, I realized that my team’s role in billing could either help or hinder this patient—that billing errors would only add to this patient’s frustration and challenges, putting an extra burden on an already difficult recovery. It is critical for us to do everything right, so that the billing process goes smoothly.
Today I encourage my team to go out and meet providers so they can understand the importance of their work in the overall picture.
#2: Invest in learning and building relationships
I like figuring things out. I read and learn everything I possibly can, going to trainings, and then asking to talk to people for more information. When I joined the enrollment team, I learned quickly that we had been doing the applications in the most time-consuming way. In 2015, Mark Zenger had become our director and led us in consolidating tax information, which meant re-enrolling every provider. During that time, I was the team lead which quickly turned into a supervisor role.
At the same time, big changes were forced on us—a new software system and an online system for Medicare. I read everything, and then thought—I have to meet these people and learn from them. I asked to be sent to an enrollment conference.
At my first conference one of the speakers was Zabeen Chong, the Director of Provider Enrollment and Oversight Group at CMS' Center for Program Integrity. After I heard her speak, I introduced myself to her, which surprised her. We talked about our challenges and needs. That connection allowed me and my team to take advantage of a myriad of trainings and resources CMS had to offer that we probably would not have known about otherwise.
I’m always encouraging my team to go out and build relationships, the liaisons for the academic departments and divisions, as well as the payers. When a new provider comes on board, my team will sometimes go to the initial staff meetings to meet him or her and get the necessary forms and signatures. Beyond getting a document signed, I encourage them to start building relationships with providers from the very beginning.
“Purpose isn’t magic–it’s something we must consciously pursue and create.”
Wise words from author John Coleman, in his article “To Find Meaning In Your Work, Change How You Think About It.” One highlight: adapt your work by “job crafting.” Studies examine hospital custodial workers who changed their job by rearranging artwork in unconscious patients’ rooms or learning which cleaning agents were safer for patients. “Treating work as craft–focusing on the skills needed to complete one’s work and dedicating oneself to perfecting skills...fills pursuits with greater purpose.”
#3: Make it easy for everyone–patients and providers
I want to make it easier for providers to practice here. The task of improving Medicare enrollment was never assigned to me, but after I took the time to learn about it and really dive deep into the process, I knew that I could make it better. I also knew that standardized processes and procedures would help the team be more efficient, which benefits the entire organization.
We’re always thinking about how to improve. We recently implemented a process that allows us to sign the applications on behalf of the provider, reducing the amount of time they need to spend with us. We’re consolidating our requests of them so that they don’t feel like they have to talk to 10 different departments in order to start working.
When we are called, often it’s because a provider is upset. We get to fix the issue, which is why building relationships with each payer is so important. Today I have a team of six enrollment specialists, and I impress upon each of them that the work we do is more than just making sure providers get paid, it’s ensuring that providers are enrolled and ready to offer care to those patients who need it most. It’s knowing that when we do our jobs well, patients don’t have to fight with insurance companies over incorrectly billed procedures, adding more stress to an already difficult time in their lives.
It’s building relationships with everyone to work together to improve health care for everyone.
From Purpose To Impact
If you’re a billing clinician, Jenn Tuero might be the most important person you’ve never met. She and her team ensure that every clinician can receive payment from Medicare, Medicaid, and commercial insurers. And, they might just be the best in the nation. In 2018, Jenn’s team earned recognition for having the nation's most accurate and rapid enrollment.
They also lead the nation in submitting online applications (many organizations still submit paper applications). A 55-page application is required to enroll in (and then get paid by) Medicare. Jenn’s team completes the application on behalf of every provider (all 3000 of them), and then re-validates the application every three to five years. Every payer has a different application process, which means more work applying and re-validating.