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5 Leadership Lessons for a Successful SBO

Analysis  |  By Alexandra Wilson Pecci  
   February 11, 2020

Terri Meier, director of system patient revenue cycle at UC San Diego Health, shares the leadership philosophy behind the organization's single business office success.

Since going live with its single billing office (SBO), UC San Diego Health's revenue cycle has increased its self-pay cash flow by almost 10% year-over-year.

Although technology and good processes are certainly part of that success (which you can read about in much more detail here) it's not everything.

Some of that success can also be attributed to good leadership from Terri Meier, CHFP, CRCR, CSMC, CSBI, director of system patient revenue cycle for UC San Diego Health.

Key to that leadership style is Meier's belief that her staff doesn’t work "for" her.

"They work with me. I think that's more of my philosophy," she tells HealthLeaders. "I don’t do this on my own. There's a team of people that have helped get to this point."   

Here are five lessons on how she manages that team of people.

Lesson 1: Demonstrate their value

Instead of typical customer service employees, Meier says she hired "knowledge workers" with many years of previous revenue cycle and customer service experience.

With that in mind, she rewrote the customer service job description, making it a more challenging and dynamic role.

In addition, the SBO staff are the highest paid in the revenue cycle, and it's the department people strive to move into, not out of.

Lesson 2: Self-direction = ownership

Meier says people who are self-employed and run their own businesses tend to have more ownership over what they're doing.

"I think it changes the level of dedication," she says.

She applies that philosophy to her management style. For instance, the employees built the SBO, its structure, and how it works day-to-day.

"They're the ones at the end of the day that are going to work the workflow, so it's got to work for them," Meier says.

That sense of ownership has continued more than two years after the SBO went live.

"I try to make them self-managed as much as possible," she says of her staff.

Lesson 3: Be transparent

Another element of self-management is transparency. Meier says her staff receives all the same success reports at the same time that she does so they can manage their own work and know they're contributing to the bigger picture.

"When they log into Epic, they see the same dashboard that I do to manage the business," she says.

Lesson 4: Let them create their ideal work environment

In addition to designing their own workflow, SBO employees at UC San Diego Health also have a say in who's hired.

"When we hire staff, everybody in this office interviews that potential candidate," Meier says. "I ask them, can you see yourself working across the hall from this person?

She also flips the question around and makes sure potential employees consider the same thing, encouraging them to interview their potential employer and co-workers and consider whether they'd fit in and work well with the people they're meeting.

Lesson 5: Always be learning

Each morning before answering customer service calls, the team huddles to review their stats from the day before, discuss lessons and ideas, and do training and education.

"We huddle every morning before we start our day. I don’t turn my [call center] phones on until 9:00," Meier says. "My staff works four 10-hour days—7:30-6:00—so from 7:30-9:00 we do training and education, just so we can get prepared for that day."

Meier presented some of this information at the December HealthLeaders Revenue Cycle Exchange, an event where revenue cycle vice presidents and directors from around the country gather to share ideas and best practices. To inquire about attending the next HealthLeaders Exchange program April 20-22 in Carlsbad, California, email us at

Alexandra Wilson Pecci is an editor for HealthLeaders.

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