Join us for Advantum Health’s Revenue Cycle Insiders series, a monthly installment where we uncover the invaluable experiences and perspectives of our company’s revenue cycle leaders and team members. This month, meet Andrea Utterback, Vice President of Operations at Advantum Health.
Question: When did you start working in the healthcare revenue cycle industry?
Answer: My journey in revenue cycle management began twenty-six years ago in a humble payment poster role at an orthopedic practice. Over time, I expanded my responsibilities to include prior authorizations and account follow-up, which laid the foundation for my career in RCM.
My career took a significant turn when I joined a healthcare system’s physician billing office, where I mastered professional billing expertise across various specialties like Rural Health, Anesthesia, Oncology, and OB/GYN, and became a certified professional coder. This progression led to my promotion to physician billing manager, overseeing the revenue cycle for over 35 clinics.
In addition to these responsibilities, I served as a System Implementation Lead, playing a crucial role in building, training, and implementing practice management and scheduling systems. Later, I transitioned into the health system’s patient financial services department as the Chargemaster Manager, further deepening my expertise in coding and billing.
Question: What attracted you to the healthcare industry, and specifically the revenue cycle?
Answer: What excites me about working in the revenue cycle space is the constant opportunity for change and challenge, an integral part of the daily routine.
I feel fortunate to be a part of the technological transformation in healthcare. When I started in physician billing, we mailed or faxed paper claims to payers and followed up via telephone or fax. While we still need to use these older forms of communication occasionally, now we can do almost all initial billing electronically.
One of the main reasons I joined the Advantum Health team was their innovative approach to enhancing revenue cycle processes and their commitment to investing in their employees. They’ve given me opportunities to grow as a leader, beginning as an Account Manager and currently serving as the Vice President of Operations.
Question: What is happening in the next six months in your area of expertise that excites you?
Answer: The next six months are brimming with potential, particularly as we delve deeper into the capabilities of AI and machine learning in the RCM space.
These technologies are poised to revolutionize labor-intensive processes such as coding, where AI models can analyze large datasets of previously processed claims to predict potential denials before submission.
At Advantum, we are leading this transformation with our proprietary software, Advantum Ai. This tool has dramatically improved our workflow management and analytics, serving as a game-changer for both our onshore and India-based RCM teams.
Question: What are some of the biggest challenges your industry faces in the short term (one year or less)? What about in the long term?
Answer: One of the most significant challenges we face, both in the short and long term, is staying ahead of the constant changes in payer policies and adapting to evolving guidelines. These rapid changes require continuous learning and agility to maintain efficiency and accuracy in revenue cycle management.
Question: If you could time travel, what advice would you give to yourself ten years ago?
Answer: I would advise myself to prioritize staying ahead of technological advancements, particularly in data and system integrations. Anticipating these changes is crucial for maintaining a competitive edge in the rapidly evolving RCM industry.
Question: What’s the best leadership advice you’ve received?
Answer: One of the most impactful pieces of leadership advice I’ve received is to focus on setting short-term, achievable goals. This approach prevents us from being overwhelmed by large tasks and allows us to make steady, measurable progress.