Gale S. Johnson
Sugar Land,TX
Summary
Seasoned VP of Revenue Cycle with a proven track record at Infusion for Health, adept in leveraging Athenahealth and collaborative leadership to surpass financial objectives. Spearheaded initiatives that slashed cost to collect significantly, while fostering team synergy to achieve a 98% clean claim rate. Expert in strategic planning and operational excellence, consistently delivering results.
Overview
25
25
years of professional experience
Work History
VP of Revenue Cycle
Infusion for Health
03.2024 - Current
- Under direct supervision of the Chief Executive Officer managed both state side internal billing team as well as offshore teams for infusion AIC clinics in multiple states
- Collaborate with shared services for authorization, benefits investigation, clinical and intake functions
- Successfully reduced cost to collect below 1%
- Created QA, SLAs & KPIs to meet RCM goals
- Added provider & facility credentialling to RCM to meet & align with constant facility growth
- Teamed up with sales to improve patient referral conversions
- Reduced days to bill to 48 hours with a 98 % clean claim rate
- Improved cash posting processes to meet 2-day KPIs & reduced unapplied payment
- Set & met claim denial KPI to < 5%
- Superseded to collect a high percentage 0-30 collections each month
VP of Revenue Cycle
Altus Community Health
10.2022 - 09.2023
- Under direct supervision of the Chief Financial Officer developed, planned, organized, and implemented current and future strategies to increase and improve cash-flow, and manage the overall health of the receivables for the Central Business Office of a private equity-backed organization
- Centralized four divisions: including Emergency Medicine divisions, specialty hospitals, and multiple ambulatory surgery centers
- Enhanced and standardized workflow processes throughout the revenue cycle to assist in achieving consistency in maintaining the critical success factors
- Reviewed, designed, and implemented processes surrounding billing, third-party payer relationships, compliance, collections, and other financial analyses to ensure that the revenue cycle is effective
- Provided leadership and direction for day-to-day operations within revenue cycle management both stateside and offshore teams to ensure all services were billed and collected accurately and efficiently
- Reduced the cost to collect from 12% to 3% by developing best practices and creating a successful CBO structure
- Created and monitored performance with KPIs- such as registration accuracy, denial rate, utilization, recoupments, charge reconciliation and accuracy, and late charges
- Placed high emphasis on developing a consistent and coordinated billing model that can sustain or improve financial performance within an evolving landscape to merge four different CBOs
- Developed a quality assurance program, KPIs, and SOPs, improving the clean claim percentage from 67% to 95-98% as well as lowering the denial rate percentage
Director of Revenue Cycle
Healix Infusion Care
07.2019 - 09.2021
- Under direct supervision of the Executive VP of Reimbursement for a large CBO for a PE-backed company
- Directed the policies, objectives, and initiatives for a large Central Business Office’s back-end revenue cycle activities
- Provided daily direction and supervision of the Collections, Patient Accounts, and Cash posting departments for 150 + infusion clients across the U.S
- Motivated and led a high-performance management team; developed and evaluated the team to ensure operations followed company policies and procedures
- Managed large outsourced – offshore third-party teams as well as stateside team members
- Collaborated activities between Business Office departments and Client Services by analyzing daily, weekly, and monthly reports to ensure proper staffing and workflow
- Monitored appropriate Key Performance Indicator reports, including staff quality and productivity, and addressed concerns as needed
- Developed quality assurance tools that monitored training needs and minimized errors
Executive Director RCM
Alteon Health
06.2018 - 06.2019
- Under the Chief Revenue Officer, directed multiple revenue cycle teams including EDI, Follow-up, Denial Recovery, Revenue Integrity, Remit Management, and Customer Service for emergency medicine, post-acute, and hospitalist divisions with one billion in annual revenue for a PE-backed company
- Successfully coordinated the return of remote workforce to large CBO
- Executed RCM CBO transition of three legacy software to athenahealth while collaborating with staff across multiple regions
- Managed multiple stateside and outsourced offshore revenue cycle teams
- Executed daily metrics which increased productivity as well as the quality of work
- Used multiple offshore billing vendors to meet established metrics and KPIs
- Extensive Medicaid and Medicare claims experience across multiple states
- Mentored and coached staff after acquisition and provided a positive culture for growth
- Analyzed denials and executed bulk appeals for in and out-of-network payers
Medical Billing Director
Humanim Inc.
10.2007 - 05.2018
- Directed medical billing, authorizations, collection, and contracts for mental health, substance abuse, brain injury rehabilitation programs, and social enterprises, under the direct supervision of the Chief Financial Officer
- Managed full revenue cycle in ED, Inpatient, Residential, OP, and Day Programs places of service
Medical Billing Manager
Sentient Medical Services
10.2006 - 10.2007
- Hired by owner and president to improve revenue cycle to be acquired by PE-backed company with success
Senior Billing Project Analyst
MobilexUsa
11.2005 - 11.2006
- Assisted Controller by coordinating all projects related to billing & collections for mobile imaging services
Billing Supervisor & Software Trainer
Planned Parenthood of MD
08.2000 - 11.2005
- Managed the billing and collections for eight gynecological satellite offices under the CFO
Education
Master of Health Administration -
University of Phoenix
Timonium, MD01.2014
Master of Business Administration -
University of Phoenix
Timonium, MD01.2008
B.A. - English
Coppin State College
Baltimore, MD01.1995
Skills
- EClinicalWorks
- Thrive
- Go-Rev
- Advanced MD
- Athenahealth
- CPU
- Collaborate
- Centricity
- NextGen
- ACCPAC
- Carevoyant (Medsys)
- Meditech
- Misys Tiger
- IDX
- Impromptu
- Medical Manager
- Medsta Med
- SalesForce
- Microsoft Excel
- PowerPoint
- Access
- Crystal reporting
- SQL reporting
Bio
Over 20 years of revenue cycle management experience in for-profit and nonprofit settings. My background includes managing multi-specialty practices, primary care, surgical groups, academic medical centers, and hospital settings. Expertise includes improving the efficiency and effectiveness in the entire revenue cycle, including increasing collections, revenue integrity, identifying trends, payer contracts, and reducing the cost to collect for private equity-backed companies. Currently, an active member of the American Association of Healthcare Administrative Management (AAHAM) to stay abreast of the constant changes within the healthcare financial industry.
Timeline
VP of Revenue Cycle
Infusion for Health
03.2024 - Current
VP of Revenue Cycle
Altus Community Health
10.2022 - 09.2023
Director of Revenue Cycle
Healix Infusion Care
07.2019 - 09.2021
Executive Director RCM
Alteon Health
06.2018 - 06.2019
Medical Billing Director
Humanim Inc.
10.2007 - 05.2018
Medical Billing Manager
Sentient Medical Services
10.2006 - 10.2007
Senior Billing Project Analyst
MobilexUsa
11.2005 - 11.2006
Billing Supervisor & Software Trainer
Planned Parenthood of MD
08.2000 - 11.2005
Master of Health Administration -
University of Phoenix
Master of Business Administration -
University of Phoenix
B.A. - English
Coppin State College
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