My career in healthcare revenue cycle began with the intention of becoming a nurse—until I realized that wasn’t the right fit for me. I wanted a career where what I did truly mattered, especially for patients and the people doing the work.

I started at Blue Cross and Blue Shield in 1985 as a claims processor, back when claims were manually keyed from paper forms. After about 10 years, I moved into leadership roles before joining Duke University Health System, where I spent 30 years in revenue cycle leadership.

Over that time, I led teams through massive industry shifts, from paper and microfiche to fully automated systems, and even navigating the pandemic when we had to move entire operations remote in just days. What kept me in revenue cycle was the impact behind the numbers. When you peel back the layers, it’s really about access, compassion, and making healthcare less stressful for patients.

Retirement didn’t look like slowing down for me. After 30 years at Duke, I thought I’d take a break and figure out what was next—but the path led me to Revco very naturally.

I had worked with Revco for years and knew the culture, integrity, and focus on relationships. It was never about transactions first; it was about relationships first. That alignment mattered to me.

Joining Revco felt like a full-circle moment from starting at a payer, to working within a health system, to now seeing the broader picture across many organizations. It’s been incredibly rewarding.

To me, it’s really simple. It’s about partnership. Transactions are important, but partnership is what moves the needle.

The vendors that made the biggest impact took time to understand the health system’s brand, culture, challenges, and goals. Success comes down to three things: alignment, transparency, and shared ownership.

If a vendor is only focused on their metrics, or a health system is only focused on theirs, silos form immediately. It can’t feel like “us versus them.” It has to feel like “we.”

When I took over EBO, bad debt, and self-pay at Duke, I didn’t initially know Revco well. I sat down with my team to understand their work, but I also reached out directly to Revco to learn the history of the partnership and the challenges they had faced.

One of the most impactful things we did was create town halls with Revco’s frontline staff. I wanted to thank them directly, engage with them, and build relationships without intermediaries. These weren’t one-time meetings, we made them ongoing.

When frontline teams feel appreciated and connected to the client’s mission, they give that energy back. They share challenges earlier, stay engaged, and take pride in the work. That’s when a partnership becomes truly powerful.

One of the biggest pitfalls is assumptions—assuming you understand a client’s needs based on another organization’s experience. Every health system is different, and assumptions create disconnects that grow over time.

Another issue is failing to define success upfront. A mentor once told me, “If you don’t define success from the beginning, you’ll never agree on whether you achieved it.”

And finally, silos. You can’t outsource work and then walk away. Ongoing engagement and early involvement from operational leaders are essential to avoid them.

Do your homework. Learn the brand, culture, pain points, and priorities. Lead with care and curiosity. Be a student of your client’s world and build trust as the foundation.

Everything we do ultimately impacts the patient. Without the patient, there is no revenue cycle.

Engage early—before and during contract discussions—and bring operational leaders to the table from the start. Avoid messaging through layers, because it changes along the way.

Stay engaged. Don’t hand off work and walk away. Maintain open communication, regular meetings, and periodic town halls. Recognition should reach the frontline, because that’s where the real work—and the magic—happens.