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Why Customer Service is the Highest-Paid Rev Cycle Position at UC San Diego Health

Analysis  |  By Alexandra Wilson Pecci  
   October 12, 2021

'We are the face of the patient financial experience,' says Terri Meier, director of system patient revenue cycle for UC San Diego Health, who shares three strategies for educating revenue cycle employees.

The revenue cycle is a critical part of every hospital and health system, but unlike coders, physicians, nurses, accountants, human resource managers, and other professionals, revenue cycle employees often don’t receive much formal education or training. Instead, many revenue cycle employees are hired at the entry level, learn on the job, and work their way up through the department.

That's why Terri Meier, director of system patient revenue cycle for UC San Diego Health, has made it her mission to provide education and training for her staff that goes beyond even the walls of her health system.

The need for well-educated and highly trained revenue cycle professionals will only become more important in the coming years, as technology automates rote tasks and expert employees are needed to handle more complicated accounts and situations.

"I think healthcare is ever evolving, and it is critical for us on the hospital and professional side of revenue cycle to keep up with the external environment and how quickly it's changing," Meier says. "That's where a foundation of educating your employees [comes in], not only in their day-to-day work and what their role and responsibilities are, but [in] keeping them abreast as to what is changing in the external environment."

A deep understanding of the revenue cycle is also needed as health systems and hospitals focus more heavily on patient experience.

"We are the face of the patient financial experience, customer service, and billing, as well as financial assistance," Meier says.

Meier told us all about the hiring, onboarding, education, and training program on the HealthLeaders Revenue Cycle Podcast. Read on for three strategies she talks about in that conversation and be sure to listen to the full interview, including how UC San Diego has partnered with a local college program for revenue cycle education and why a transparent management style is so important.

1. Provide a thorough onboarding process

Training on the end-to-end revenue cycle process via the EMR and completing customer service skill courses are just part of the extensive onboarding process that employees go through at UC San Diego Health.

Showing a high level of competency is required before they're ever put on the phone. For example, they need to test at 80% or greater for each of the customer service attributes they're trained on first. They also receive tip sheets and situation response guides to help them in customer service conversations.

"They know where they can go to find the answer to the patient's question," Meier says. "This way, they've got tools in their toolkit to be able to manage that conversation with the patient."

Another part of the onboarding process is shadowing and working side-by-side with each of Meier's team members, not only so the new employee can get to know their team but also to ensure that all employees are using the same consistent, standard workflows.

That's because when patients call customer service, it won't matter which customer service representative they reach.

"They're going to get the same experience, which is really important to us," Meier says.

2. Turn the career ladder upside down

Customer service usually is the easiest place for revenue cycle employees to start out, "and as soon as a billing job opens up, you lose that customer service rep to that billing job," Meier says.

That's not the case at UC San Diego, where customer service is the highest-paid revenue cycle position.

"UC San Diego actually was very invested in making that patient financial experience a differentiating factor. So much so that they have allowed me to hire knowledge workers," Meier says. "Customer service is hard because it's not only knowing the answer to the question, but it's also managing that human interaction with that patient. Most of the time … the reason why the patient is calling is because they have a problem, so it's not always an easy conversation to manage."

But with a higher salary comes "a higher expectation."

"My team is expected to know the end-to-end revenue cycle from the point of scheduling all through cash posting so we can figure out where the break is in the process when patients come [to us] with those problems," Meier says.

3. Make sure that education is ongoing

UC San Diego supports ongoing, day-to-day education in many ways, including daily huddles, where team members can bring up issues they are experiencing, find the root cause of the problem, and implement corrective action.

They also do annual competency testing and quality assurance reviews; have an education committee; and have applied for HFMA enterprise membership, "so all of our team members will be CRCR [Certified Revenue Cycle Representative] certified as part of our offering to them," Meier says.

Such ongoing education and quality assurance allows UC San Diego's revenue cycle employees to be laser-focused on their mission.

"I always told them that their first responsibility is to be the voice of the patient," Meier says. "The education really provides us with a good foundation to be able to deliver on that first-call resolution."

That focus is reflected in its metrics and cash collections. For instance, it has a 0.02% abandonment rate, and its service level is 99.87.

"It builds trust and loyalty with our patients," Meier says. "They call us because they know we can get the answer to their question and we're very proud of that."

Listen to our full interview with Terri Meier on the HealthLeaders Revenue Cycle Podcast.

Alexandra Wilson Pecci is an editor for HealthLeaders.


The need for well-educated and highly trained revenue cycle professionals is crucial as technology automates rote tasks and there's a greater focus on the patient financial experience.

A thorough onboarding process and ongoing education are critical to revenue cycle education.

Customer service reps are the face of the patient financial experience and being able to help patients builds loyalty and trust and improves key metrics and cash collections.

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