Policeman, Fireman, Medicare Biller?

It might not be on a short list of dream jobs for many, but Kraig Couture has put his finance skills to use to give patients an ideal billing experience and drive revenue for Vibra Healthcare—finding a dream job along the way

“Nobody grows up saying, ‘I want to be a Medicare biller,’” says Kraig Couture, vice president of revenue cycle at Vibra Healthcare. Despite that fact, the healthcare industry continues to see more and more patients each passing year, which means more and more bills need to be filed, processed, and collected. The increasing complications of the insurance industry only make those demands more pressing.

Couture might not have grown up wanting to be in the healthcare industry—or a revenue cycle expert for that matter—but after high-level accounting stints at major organizations like 20th Century Fox and ITT Sheraton, he found a new home at Vibra. Couture was hired initially as chief financial officer for two of the system’s hospitals, though he didn’t expect to get an offer. “I honestly didn’t think I would get the job, but I thought my strong accounting and finance background would be beneficial,” he says. “I realized in the interview process that knowing healthcare wasn’t the sole concern. As long as you had a strong, diverse background, you would do very well.”

Kraig Couture, Vibra Healthcare

There was a learning curve, to be sure—even in terms of language. The healthcare-specific vocabulary and acronyms added a layer of difficulty to the already complex financial work. But Couture had already worked in many different fields, each with its own methodology and mission. In fact, his first job as a teenager working in fast food actually proved to be a recurring source of inspiration. “A lot of the customer service-focused work at McDonald’s has been useful for my whole career,” he says. “McDonald’s biggest thing is customers. When I started in healthcare, others would laugh when I called people customers in meetings. But though they might be our patients, they’re really our customers, and we want to leave them with the best impression of our company.”

One of the best ways to leave that lasting impression is by providing patients with a positive billing experience. Early in his tenure, Couture wrote a white paper that proposed consolidating billing operations across the company—a move that would make a major impact on the growing organization. “In previous roles, I saw why standardization works and how consistent documentation procedures, training, and streamlined processes saved money,” he says. Eventually, the grouping of hospitals grew from six to more than fifty, the team that had been bringing in $1 million a month was bringing in $80 million, and Couture rose to the position of vice president of revenue cycle.

Couture, however, still gets hands-on with every step of the process. He designed the structure of the office. In fact, he stays up-to-date on all the necessary details to keep things functioning smoothly. “Unless you are in the departments with the staff helping out when needed, you won’t know what’s going on,” he says. “Every position in the business office is equally important as the other, and you have to be willing to jump in and help whenever and wherever help is needed. Leading by example is so important to the staff, along with having a strong management team to support you and your vision. I have to have the pulse of what’s going on because healthcare is always changing.”

Even after providing the best care possible, an incorrect or mishandled bill will leave the patient with a bad reaction. Vibra Healthcare focuses on providing the best possible experience. But on the rare occasion someone isn’t happy with their experience, Couture and the team have committed themselves to going above and beyond to connect the patient with the right office to find an answer. Essentially, Couture wants every person who gets off the phone with the billing department to come away ready to recommend Vibra to a friend in need.

But, of course, proper billing is essential to the organization, too. In order to keep the hospital running, the team needs to not only bill patients, but also collect on payments. Learning that element of the business and how best to work with payers and insurance companies provided a major challenge early in Couture’s career. However, by this point, it’s become an area of strength. By working with technology and billing vendors, Couture has helped Vibra further automate, streamline, and bolster processes to continue to drive growth. By billing out over 75,000 claims a year and accepting over 145,000 payments, Couture and his team continue to look for ways to streamline the revenue cycle.

And though there might not yet be many kids growing up dreaming of a career as a Medicare biller, Couture knows firsthand there’s plenty of opportunity for an individual with a strong accounting skill set to make a real impact on the health of others. “We have some employees who have absolutely no healthcare experience who have done very well because they come in like a sponge, wanting to learn,” he says. “I didn’t have a healthcare background, and I’ve done pretty well.”