Kristie M. Johnson
Richmond
Summary
Experienced Administrator with a demonstrated history of working in the medical industry. Proven leadership, and multi-tasking skills with the ability to effectively manage two multi-specialty clinics simultaneously. Skilled in Visio, Epic Resolute, Customer Service, Medicare, Revenue Cycle Management, Project Management of new clinic constructions, SharePoint, SlicerDicer, and U.S. Health Insurance Portability and Accountability Act (HIPPA). Strong healthcare services professional with a Master of Business Administration-MBA. Results oriented professional with twenty three years of clinical and revenue cycle management experience. Detail oriented and proven expertise in driving financial health and business development. Strong operational manager with strengths in ensuring high customer satisfaction and consistent revenue growth.
Overview
18
18
years of professional experience
Work History
Senior Manager
Kelsey Seybold Clinic
08.2023 - Current
- Effectively manage Springwoods Village Campus in Spring, TX with 29.0 providers and subspecialties with the capacity to grow to 55 providers
- Maintain an organizational FTE ratio goal of 2.6 or below monthly
- Collaborate with Managing Physician to determine appropriate MD/support staff ratios for each department
- Strategize with the North Region Senior Director of Operations to achieve the goals of the organization
- Epic Super-User for design, build, and validation of Epic Resolute Professional Billing applications
- Develop and implement more efficient operational workflows for front and back-office staff
- Develop team and help build morale by implementing SWV Employee Engagement Committees
- Assist providers in operational efficiencies, protocols, and workflows
- Manage provider templates, edit, create, and make efficiency edits in Epic
- Design workflows and workqueues for process redesign of Epic Resolute Professional Billing
- Compile referral patterns, demographics and trends in service utilization, and competitive forces for clinic service lines to identify and pursue growth opportunities
- Develop and recommend clinic operating budget and ensure compliance with approved budget
- Coordinate with Clinical Education, and EHS department to ensure all clinical staff is meeting requirements to perform their specific job duties while ensuring that they are working within their clinical scope of practice
- Establish front end edits in Epic that front desk processes
- Front end edits are put in place to catch all errors that may impede a clean claim from going to the insurance company
- Manage physical resource utilization including space planning, asset management, and inventory control and property maintenance
- Plan physical resource needs and managed physical relocations and renovations
- Execute plans with minimal disruption to daily operations
- Detail oriented and effective management skills for policy setting, management of clinical and administrative staff, budget control, project management, billing, insurance, revenue cycle management, etc
- Consistently monitors monthly balances and reconciles all accounts
- Provide required budgetary and financial reports
- Determine trends in operational performance and identified process improvement opportunities
- Perform staff reviews and prepare performance documents for direct reports annually
Manager II Women’s Services
Texas Children's Hospital
01.2019 - Current
- Identified trends and areas of focus and help to develop and implement action plans to increase collections and monitor performance standards
- Collaborated with Medical Director to determine appropriate MD/support staff ratios for each area of the clinic
- Strategized with the Director of Operations, and AVP of Operations to achieve the goals of the organization
- Implemented strategic process improvement initiatives
- Developed and coordinate accounts receivables, charge entry, claim denials, follow up, claims and payment posting activities of the Business Office to ensure attainment of corporate goals and objectives
- Directed and managed billing and collections of all insurance and self-pay accounts
- Proven success in revenue cycle management
- Directed and managed all areas of business office within the clinic
- This includes insurance verifications, coding and billing, Front Desk collections, medical records, and patient financial counseling services
- Super-User for design, and validation of Epic Resolute Professional Billing applications
- Detail oriented and effective management skills for policy setting, management of clinical and administrative staff, budget control, project management, billing, insurance, revenue cycle management, etc
- Maintain continuous efforts to improve operations; decrease turnaround time, streamline work processes; and work cooperatively and jointly with internal departments to provide quality customer service
- Consistently monitored monthly balances and reconciles all accounts
- Provides required budgetary and financial reports
- Determined trends in operational performance and identifies process improvement opportunities
- Ensured the clinic is prepared for Environmental Health and Safety, and Joint Commission surveys
- Provided training, coaching, and development of team members to meet performance expectations and demonstrate continuous growth and development
- Provided tracking and trending of problem areas, as well as measurement of improvement against clearly defined benchmarks such as Press Ganey Customer Service initiatives
- Developed procedures and processes to improve efficiencies and reduce net revenue leakage due to denials
- Utilizes internal change management resources to effectively communicate new procedures to coding staff, physicians, front desk, and clinical staff
- Ensured delivery of quality, cost effective patient care within family-centered care environment by coordinating and participating in service-based and cross-functional performance improvement activity that improves patient access/flow, patient/family satisfaction, referring physician satisfaction, research and clinical outcomes, or employee acquisition, satisfaction, and/or retention
- Budgeted for plans to realize expected levels of professional fee and technical revenue, accounts for and routinely reports on status and changes in revenue and generates action plans to address financial issues
- Monitored operation of a budget-sensitive service model, including departmental staffing requirements and productivity levels by establishing, and/or contracting for related service performance from other departments
- Managed physical resource utilization including space planning, asset management, and inventory control and property maintenance
Manager PBS Government Insurance Follow Up, and Billing
MD Anderson Cancer Center
05.2022 - 08.2023
- Billing and claims management for front end, Clearinghouse, and backend payments or denials
- Managed claim edits for all payors including but not limited to Government, and Commercial
- Established a collaborative relationship with ClaimSource, and Experian to ensure claims processing and submission daily
- Worked to decrease high dollar and aged claims in each assigned claim edit workqueue
- Collaborate with external departments including but not limited to coding, Radiology Oncology Coding, Financial Clearance Center, Customer Service, Payment Posting to provide quality to our patients
- Identify trends and areas of focus and help develop and implement action plans to increase collections and monitor performance standards
- Developed and maintained billing and collections processes to improve cash flow and reduce bad debt
- Managed new and aged A/R greater than 90 days by tracking accounts receivable data to identify trends for our internal team members, and agencies
- Compiled, analyzed, and reported data regarding performance and trends including areas such as claims, denials, and payments
- Assisted with hiring, disciplinary actions, separation, performance evaluations, and various aspects of staffing and administration of assigned staff members
- Maintained patient and company confidentiality
- Completed projects, and special assignments by establishing objectives, determining priorities, managing time, gaining cooperation from others, monitoring progress, problem solving, and adjusting to growing change and threats to A/R management
- Ability to troubleshoot, and resolve any contracting issues
- Worked closely with the Epic OneConnect Team to identify areas of improvement for the insurance follow up and claim workflow
Clinic Administrator II
Kelsey Seybold Clinic
09.2009 - 02.2017
- Effectively managed two clinics within the Katy area for six years
- Project Manager for two KSC new constructions
- (Cinco Ranch clinic August 2010 and new Katy Clinic March 2016)
- Specialties included: Orthopedics, Pediatrics, Internal Medicine, Family Medicine, Cardiology, Gastroenterology, Urology, Pulmonary, OB/GYN, General Surgery, Dermatology, and Chiropractic
- Collaborated with Managing Physicians to determine appropriate MD/support staff ratios for each department
- Strategized with the Director of Operations and VP of Operations to achieve the goals of the organization
- Super-User for design, build, and validation of Epic Resolute Professional Billing applications
- Designed work flows and workqueues for process redesign of Epic Resolute Professional Billing
- Established and maintained control profit loss for the clinic; reviewed and presented capital equipment proposals
- Managed, monitored, and reported on program budgets
- Provided strategic leadership to develop, implement, manage compile, update and analyze market share and patient origin data
- Compiled referral patterns, demographics and trends in service utilization, and competitive forces for clinic service lines to identify and pursue growth opportunities
- Planned, developed and trained clinical (MA's, LVN's, and RN's) and administrative staff to promote quality patient satisfaction
- Developed and recommended clinic operating budget and ensure compliance with approved budget
- Developed and established clinic operating policies; participated in development and recommendation of corporate policies and goals
- Coordinated with Clinical Education department to ensure that all clinical staff is meeting requirements to perform their specific job duties while ensuring that they are working within their clinical scope of practice
- Established front end edits in Epic that front desk processes
- Front end edits are put in place to catch all errors that may impede a clean claim from going to the insurance company
- Onboarded new physicians based on data metrics of patient demographics obtained from the Department of Economic Development and the Katy Chamber of Commerce
- Worked with the marketing department to pursue alternatives to generate incremental revenue for both clinic locations and Kelsey wide
- Controlled cost by establishing budgets of $7.9 million by monitoring expenses on a monthly and quarterly basis
- Managed physical resource utilization including space planning, asset management, and inventory control and property maintenance
- Planned physical resource needs and managed physical relocations and renovations
- Executed plans with minimal disruption to daily operations
- Detail oriented and effective management skills for policy setting, management of clinical and front desk staff, budget control, project management, billing, insurance, revenue cycle management, etc
- Consistently monitored monthly balances and reconciles all accounts
- Provides required budgetary and financial reports
- Determined trends in operational performance and identified process improvement opportunities
- Identified and implemented process improvements to lower costs and improve services to facility customers
- Performed staff reviews and prepared performance documents for direct reports annually
Business Services Supervisor
Kelsey Seybold Clinic
11.2006 - 09.2009
- Supervised 20+ staff members with a focus on insurance follow up and claims submission
- Developed and coordinated accounts receivables, claim denials, follow up, claims and payment posting activities of the Business Office to ensure attainment of corporate goals and objectives
- Directed and managed billing and collection of insurance and self-pay accounts for 360+ physicians in a multi-specialty multi-payer environment
- Proven success in revenue cycle management
- Supervised departmental activities and conducted random audits of staff assignments
- Provided feedback and training based on denial trends and claim edit trends from Epic and the claims clearinghouse
- Established and maintained Follow Up W/Q workflows and implemented process improvements for Follow Up and No Activity W/Q’s for Government, PPO, HMO, etc
- Payers
- Generated monthly volume, financial and statistical reports of office/area performances to the Director of Business Office
- Identified trends and areas of focus and helped to develop and implement action plans to increase collections and monitor performance standards
Education
Master of Business Administration -
Texas Woman’s University
05.2017
Skills
- Epic Certified Professional Billing and Collections
- Revenue Cycle Management
- Patient Access Management
- Contract Management
- Provider Credentialing
Committees Software Memberships
Bad Debt Initiative Committee, Patient Education, Coding and Billing Optimization Committee, Revenue Cycle, Referral and Utilization Review, QAPI (Chart Review), Administrative Practice Council, SharePoint, Visio, Epic, Vision EMR, IDX, SN Charts, Microsoft Applications, Surgical Information Systems, Slicer Dicer, AAPC Member (American Academy of Professional Coders), Alpha Kappa Alpha Sorority, INC., Texas MGMA Member (2010-2017), Certified Epic Resolute Professional Billing Insurance and Self - Pay Follow Up through 2018, Healthcare Leaders Association of Texas (08/01/23-Present)
Timeline
Senior Manager
Kelsey Seybold Clinic
08.2023 - Current
Manager PBS Government Insurance Follow Up, and Billing
MD Anderson Cancer Center
05.2022 - 08.2023
Manager II Women’s Services
Texas Children's Hospital
01.2019 - Current
Clinic Administrator II
Kelsey Seybold Clinic
09.2009 - 02.2017
Business Services Supervisor
Kelsey Seybold Clinic
11.2006 - 09.2009
Master of Business Administration -
Texas Woman’s University
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