RCM Connections August 2025

Medicaid and ACA: 7 changes to make before 2026

Untapped Referral Technology Playbook

Heather Wolf Explains Why Customer Service is your Growth Engine

KEISHA DOWNES

Vice President, Middle Revenue Cycle

Jena R. Eggert

Founder&CEORCR|HUB

BACK TO SCHOO

Greetings,

As summer winds down and our neighborhood kids head back to school (you know, in Florida, we start early), I can’t help but reflect on what a fantastic summer it’s been! We’ve celebrated two of our interns graduating and landing jobs, and one of our favorites is headed to London to continue her graduate studies. Three for three! Thanks to you, our RCM CommUnity, for your support in leaning into the future.

Back-to-school season always feels like a fresh start, and this year is no exception.

This month, I had the pleasure of interviewing Keisa Downes. Like me, I think you’ll find her to be a forward-thinking leader who is motivated to lean into new technology while inspiring others RCM is in good hands with leaders like her at the helm. She’s even back in school herself, Go Huskies!

As I look over our final copy, I would like to thank our sponsors for your continued support This month alone, we’ve already welcomed thousands of visitors, and the magazine hasn’t even been released yet! To providers, thank you for using the site. And to our prospects: Join Us!

Friends, finish August strong Enjoy your long Labor Day weekend you’ve earned it.

My best, Jena

KEISHA DOWNES BACKTOSCHOOLWITH

Vice President, Middle Revenue Cycle

Jena Eggert: Thank you for joining us in this August issue of RCM Connections. Keisa, I’ll hand it over to you

Keisha Downes: I am the Vice President of Mid Revenue Cycle for Beth Israel Lahey Health.

Jena Eggert: In your current role, with your educational background we know you’re an RN how does that experience play into your work?

Keisha Downes: In Mid Revenue Cycle, I'm overseeing CDI, HB, and PB coding, as well as HIMI. Like you said, I began my career as a registered nurse and never intended to get into Revenue Cycle. I didn't even realize this part of healthcare existed. I was at a crossroads in my nursing career and wasn't sure what my next step would be. I went to a job fair, and in the corner, there was CDI, sitting very quietly I wasn't sure what it was I looked at the job description, which included a lot of acronyms like DRG and SOI terms I had never heard before. However, they explained what the job involved, almost like a hidden picture. It was like playing Where's Waldo right in front of you It seemed like an exciting role that would let me combine my clinical experience with this new learning. That's how I got into CDI

From there, I continued to grow within the revenue cycle, gaining a better understanding of where CDI fits in, how we coordinate with the clinical side, patient accounts, and billing. My curiosity grew as I learned more about coding and HIM This journey has really propelled my career to where I am today.

Jena Eggert: With your medical background, do you build teams differently from your peers?

Keisha Downes:I understand the clinical side. I've worked very closely with clinicians, literally elbow to elbow, so I know what they experience daily and their challenges. Now, understanding that there's this whole other element in the background reaching out to them, asking for help, and expecting them to do what is needed, shifts my perspective a bit. Instead of saying, "I need this because of a coding guideline," it's more about representing their work, the acuity of our care, and the acuity of our patients this is how we show it. Because of my personal experience, I believe I can approach it differently.

Jena Eggert: When we talk about experience and technology in RCM, the buzzword is AI. As AI advances, how are you incorporating technology into your education and leadership?

Untapped Referral Revenue Technology Playbook

EmergingTechnology

TransformingUntapped ReferralRevenue

AI-PoweredReferral Analytics

AIplatformsanalyze clinicalrecordsto identifymissed referrals instances wherepatientsdid notschedule recommended procedures

PredictiveAnalyticsfor ReferralManagement

AItoolspredictwhich referralsareatriskofnot beingcompleted,allowing healthcareprovidersto proactivelyinterveneand ensurepatientsreceive recommendedcare.

AutomatedPatient

Outreachand

Scheduling AI-driven systemsautomate patientengagement throughtexts,emails, andcalls,educating patientsonnecessary proceduresand facilitatingscheduling, therebyreducing referralleakage.