September 26, 2012
Upon review of the briefing document for DocSystems Billing, Inc., it is clear that problems exist within the organization, both at the surface along with potentially some underlying issues in the teams. In order to present a recommendation to the client, it will be important to identify the problems that exist within the organization, analyze how these problems differ within each area of the organization, and understand why the employees did not like a proposed process change to improve the situation. The recommendation will include a summary of observations, interpretations, and options for next steps. I will start with looking at the basic problems identified at the organization level as reported by Jim, the senior director in the organization. Jim is concerned about the overall processing times at the call center, including ensuring physicians get payments quickly and patient problems and appeals are services in a timely manner. By asking more detailed questions, it seems the issue is not related to the Billing Specialist team (which was recently outsourced), but is more focused within the MIS (Medical Insurance Specialist) team, which is one of the teams that report thru a manager to Jim. Jim explained that the payment processing starts with the Billing Specialists, and gets escalated to the MIS team when problems arise with a payment. Jim explained that the delays in processing seem to be coming from this team due to heavy workload and juggling questions from the Billing Specialist team. He provided the example of the Platinum Tier physicians, who expected resolution in two to three hours, but are not getting issues resolved for fifteen hours. If the MIS team cannot resolve a payment issue, the payment can then get escalated to the SIC (Senior Insurance Consultants) team, who deal with the very complex payment processing, but this handoff does not seem to be happening on a regular basis. The SIC team also reports thru a manager up to Jim. Ultimately, Jim is looking for more collaboration on the teams to get the customer satisfaction increased. After finishing my conversation with Jim, I asked to talk to some of the team members of the SIC team and the MIS team. I was surprised to hear a different perspective from these teams. I initially met with Rosie from the MIS team. I observed her work environment and asked questions about her role. She explained the various cases she was currently working on and explained that she was waiting to hear back from either physicians or patients on many of the cases. We discussed one case in particular that seemed very complex, and when I asked if she ever escalated these types of cases, she informed me that she liked working her own cases. Then an underlying issue was uncovered when she raised the concern that her job would be outsourced if she did not handle everything. When I asked her about the potential for the SIC team to share the workload, another underlying issue came to light with her response that big brother would be watching over her. Next, I met with Carlos, who is on the SIC team. He had been at the company for nineteen years and seemed very confident in his abilities. I observed that his work load was significant less than Rosie and discovered that this was a fairly typical situation. During my conversation with Carlos, he pulled one of his team members, Michelle, into the discussion. As they talked more about their work load, an underlying issue surfaced when Michelle commented about the re-organization and the lack of interaction with their new manager. They also commented on the fact that they all received the same standard raise each year, no matter how much work was completed. I gleaned that they had no motivation to take on more work because they were not paid for their performance. The next day the team assembled for a design session to discuss a...