Jennifer Pawlishn

• Serve as the primary architect of RCM success for enterprise-sized medical practices, cultivating high-value relationships to align complex billing needs with organizational growth.
• Establish and manage Practice Performance Plans, identifying and quantifying service-level gaps to ensure 100% delivery of contractual obligations and SLAs.
• Conduct high-level business reviews and audits, leveraging advanced metrics to provide proactive recommendations that optimize the revenue cycle and increase net collections.

• Managed a diverse portfolio of healthcare clients, resolving escalated concerns and ensuring a seamless feedback loop between internal technical teams and stakeholders.
• Facilitated end-to-end project execution, tracking deliverables and proactively mitigating roadblocks to exceed client expectations during critical system implementations.
• Analyzed client feedback to refine service delivery and improve user experience.
• Cultivated strong client relationships to enhance satisfaction and retention.

• Oversaw a team of 45 RCM professionals managing services for 250+ clients; standardized workflows to slash denial rates and accelerate cash flow.
• Developed advanced A/R tracking dashboards, providing real-time visibility into financial trends for executive-level decision-making.
• Streamlined revenue cycle processes to improve cash flow and reduce days in accounts receivable.
• Led team initiatives to enhance billing accuracy and compliance with regulatory standards.

• Directed comprehensive RCM operations for a portfolio of Federally Qualified Health Centers (FQHC), ensuring adherence to unique regulatory requirements and charge capture accuracy.
• Orchestrated a geographically dispersed billing team; improved performance through targeted training and KPI alignment, significantly reducing A/R aging.
• Developed strategic initiatives to optimize revenue cycle management and improve cash flow.
• Oversaw billing operations, ensuring compliance with healthcare regulations and industry standards.
• Mentored and trained staff in medical coding best practices and billing software utilization.

• Presented high-level financial summaries to stakeholders, highlighting reimbursement trends and payer performance to guide long-term fiscal strategy.
• Streamlined revenue cycle processes, enhancing operational efficiency and reducing claim denial rates.
• Led cross-functional teams to implement strategic initiatives, improving overall revenue collection performance.
• Led revenue cycle initiatives to optimize billing processes and enhance cash flow management.
• Implemented strategic improvements in claims processing to reduce denial rates and improve collection efficiency.

• Managed full-cycle RCM for 15 private practices; implemented tailored reporting tools that isolated reimbursement gaps and improved operational transparency.

• Led end-to-end RCM onboarding for new clients, customizing payer rules to maximize first-pass acceptance rates.
• Created a comprehensive payer rules database supporting automated claims scrubbing, achieving a 97%+ first-pass acceptance rate.
• Collaborated with cross-functional teams to customize software solutions for diverse client needs.
• Led implementation of electronic health record systems, enhancing workflow efficiency across multiple departments.
• Analyzed client requirements and provided strategic recommendations to optimize system utilization.
• Served as primary point of contact for client inquiries, ensuring timely resolutions and high-quality service delivery.

• Established and updated a payer rules database to facilitate clean claim submissions and ensure high first-pass acceptance rates.
• Coordinated testing, deployment, and updating of billing logic to ensure compliance with evolving payer policies and industry regulations.
• Evaluated and integrated updates from payer bulletins and regulatory changes to enhance billing accuracy and reduce denial rates across client accounts.
• Analyzed denial patterns extensively and worked cross-functionally with billing teams to create and apply payer-specific strategies that optimize claim accuracy and revenue outcomes.

Oversaw comprehensive insurance claim submissions, monitored clearinghouse reports, and addressed claim rejections to maintain efficient processing and steady revenue streams.

Managed daily task assignments, performance tracking, and new hire training to uphold departmental goals and ensure precise billing standards.

Utilized extensive policy knowledge to investigate and rectify complex claim issues, fostering collaboration with internal teams and external payer representatives to enhance resolution efficiency.

Facilitated accurate and timely reporting on claim statuses and denial resolutions, enhancing accountability and transparency within billing team.

• Converted the entire billing operation from manual paper-based processes to streamlined electronic systems, increasing submission speed and accuracy.

• Developed outpatient practice policies for Medicare/Medicaid compliance and managed complex provider credentialing.
• Analyzed data trends to support strategic decision-making and improve resource allocation.
• Developed and implemented streamlined operational processes to enhance project efficiency.