John Madison Email & Phone Number

Liberty Hill, Tx, Us

Remote

As supervisor of the Payment Integrity Team (PIT) I manage 7 full time employees. My team is responsible for working clinical and authorization denials as well as ensuring we receive our expected reimbursement from contracted payers and Medicare and Medicaid. I work closely with the Contracting department and Case Management to escalate any trending or high level issues. I also analyze historical reimbursement for different areas of the hospital network looking for reimbursement improvement opportunities.

I worked with our contracted payers to ensure we received our expected reimbursement. I identified areas of underpayment and escalated issues to our Contracting department and our payer representatives.

I worked on the Follow-Up Team calling insurance companies to ensure processing of claims.

Remote

• Lead a team of 3 for our Illinois clients, focused on operational denial improvement.• Lead a team of 5 responsible for identifying and deploying global denial solutions around outpatient authorization denials.• Utilized project management strategies and tools to manage expectations, clearly state and communicate steps to completion of the project, and monitor outcomes over an extended period of time.• Worked across multiple teams, both internal and external, including clinical staff in an effort to identify opportunities and deploy solutions.

Austin, Texas Area

Led team of three, accountable for denial improvement initiatives and overcoming and preventing final denials for our Texas market. Presented denial information and project initiatives to key market stakeholders including the client’s CFO. Instrumental in the creationand implementation of a clinical denial playbook used company-wide.• Managed project initiatives to ensure clear and timely movement on implementation and denial reduction.• Worked cross-functionally and collaboratively with clinical and operational departments on process improvement and specific accounts for positive resolution.• Reduced market’s denials by 41% from FY18 to FY21. • Implemented multiple process improvement measures to decrease chance of denials.John Madison, Page 2• Created and implemented denial prevention process for Oncology; later identified as best practice and deployed nationally.

Round Rock, Tx

Managed team of over 50 employees, including Patient Access, HIM, Billing, and Follow-Up. Accountable for all aspects of the revenue cycle metrics and operations. Presented weekly and monthly metrics to key stakeholders and organization owners. • Executed growing revenue cycle and its operations/priorities, which included two new hospitals and management contract.• Implemented software to improve revenue cycle performance, including cash posting, patient access, and reporting software.• Managed over $20M in accounts receivables.• Led growing team of leaders while going through rapid change with lower-level associates that included ramping up temporary employees, office space changes, temp-to-full employees, and remote associates, all with limited turnover.• Maintained average AR days in alignment with expectations of organization. • Increased front-end cash collections.

Master'S Degree, Health/Health Care Administration/Management

Bachelor Of Science (Bs), Finance, General