Shawn Pruitt
R1 RCM
Tell City,IN
Work Preference
Work Type
Full Time
Location Preference
Remote
Important To Me
Career advancementWork-life balanceCompany CultureHealthcare benefitsPaid time offWork from home optionPersonal development programsFlexible work hoursPaid sick leave401k match
Revenue cycle operations leader leading AR follow-up, denials management, and collections across 28 Ascension Indiana hospitals supporting a $2.1B AR inventory, $41.1M average daily revenue, and approximately 776K claims through a 26-associate multi-level onshore and offshore organization while resolving 50+ payer issues per month and advancing denials management, collections, and reimbursement strategy across hospital and specialty-care environments. Partners with executives and operational leaders to resolve payer barriers, strengthen workflow design, and support automation initiatives with 20+ workflow design, testing, and adoption tasks that improve cash acceleration and AR performance. Brings direct oversight of multi-level teams and large-scale claim inventory.
2
Certifications
27
Years of experience
4
years of post-secondary education
Work History
Manager, Revenue Cycle Operations
4 Years 5 Months
R1 RCM - Remote | 05.2022 - Current
- Lead AR follow-up, denials management, and collections across 28 Ascension Indiana hospitals, supporting a $2.1B AR inventory, $41.1M average daily revenue, and approximately 776K claims through a 26-associate multi-level onshore and offshore organization.
- Lead operational recovery efforts following two cyber-related claim submission disruptions, contributing to approximately $1.25B in AR reduction, improving AR days from 65.48 to 52.41, and reducing unworked and overdue AR from 1.9 to 0.20 days.
- Partner with executive leadership, Patient Access, HIM, Coding, Billing, IT, and payer organizations to remove reimbursement barriers and accelerate cash collections.
- Support implementation of R1's PhareOS automation platform through workflow design, testing, user adoption, and operational change management.
- Establish KPI accountability and performance management across managers, supervisors, team leads, and associates to strengthen productivity and operational discipline.
- Direct Auto Liability and Workers' Compensation revenue cycle operations, overseeing complex payer reimbursement and recovery processes.
- Provide guidance to onshore and offshore teams while balancing workload, escalations, and day-to-day execution across revenue cycle priorities.
- Led revenue cycle operations, aligning workflows with patient access, billing, and collections priorities.
- Managed staff performance, coaching team members on service standards, accuracy, and productivity expectations.
Patient Access & Analytics Operations Manager
4 Years
R1 RCM - Nashville, TN | 05.2018 - 05.2022
- Raised clean data transmission 38% by standardizing data formatting, reducing first-pass edits and upstream denials.
- Review 250 registration records weekly to catch data issues before claims submission.
- Oversaw registration, authorizations, eligibility, and benefit verification for back-end patient access across multiple hospital workflows.
- Improved registration accuracy through standard processes, coaching, and team training focused on consistent front-end documentation.
- Partnered with IT, HIM, billing, and operations leaders to resolve front-end data problems and strengthen downstream workflow quality.
- Directed daily revenue cycle operations, aligning workflows with service-level expectations and client requirements.
- Monitored key performance indicators, identifying process gaps and implementing corrective actions across billing functions.
Billing, Charge Entry, and EDI Data Analyst
7 Months
JourneyPure - Murfreesboro, TN | 05.2017 - 12.2017
- Monitored 500 277/277CA payer responses weekly to catch billing file issues before payment delays.
- Tracked 75 billing exceptions daily across charge entry and remittance workflows to support timely reimbursement.
- Managed patient census, charge entry, and billing for a substance use disorder treatment provider.
- Investigated 277/277CA payer responses and resolved billing file problems before they delayed payment.
- Supported accounts receivable follow-up and collections activities to accelerate reimbursement and reduce outstanding balances.
Manager of Patient AR and Customer Service
3 Years 5 Months
Covenant Surgical Partners - Nashville, TN | 11.2013 - 04.2017
- Processed 1500 patient accounts weekly through a patient collections and customer service call center serving multiple clients.
- Collected $4 million in patient balances during the first quarter by tightening workflows, coaching staff, and setting clear collection expectations.
- Managed cash posting, customer service, and patient collections across daily operations.
- Created SOPs, workflows, and training programs to standardize revenue cycle operations.
- Interviewed, hired, trained, and coached associates to strengthen team performance and service quality.
- Oversaw vendor relationships and contract negotiations for patient statement, mailing, and third-party collections partners.
- Led cross-functional teams to improve operational consistency and service delivery.
- Developed department goals aligned with organizational objectives and performance expectations.
- Oversaw staffing, scheduling, and resource allocation to maintain workflow continuity.
- Implemented process improvements that strengthened efficiency and reduced operational risk.
- Evaluated procedures and compliance requirements to maintain quality standards.
AR Follow-Up and Cash Management
1 Year 6 Months
Tennessee Orthopedic Alliance - Nashville, TN | 05.2012 - 11.2013
- Managed follow-up on unpaid orthopedic claims, resolving balance issues and keeping accounts moving toward reimbursement.
- Reconciled daily payments against remittance detail to confirm posting accuracy and identify discrepancies for correction.
- Processed balance adjustments and refunds while maintaining clean account records and consistent cash management support.
EDI Technical Research Analyst
5 Years 6 Months
Change Healthcare - Nashville, TN | 01.2000 - 07.2005
- Analyzed claim edits, rejection patterns, and payer responses to identify root causes and accelerate resolution.
- Coordinated follow-up with internal teams and external payers to close complex submission and eligibility gaps.
- Documented issue trends and recurring defects to support operational reporting and process improvement efforts.
Education
Master of Science - AI Business Strategy
Eastern University - St. Davids, PA
10.2026 - 05.2029
(in progress)
Bachelor of Science - Healthcare Administration
Western Governors University - Salt Lake City, Utah
08.2025 - 08.2026
Skills
Denials management
Revenue integrity
Reimbursement optimization
Cash acceleration
Operational reporting
Patient access operations
Process improvement
Root cause analysis
Certification
Certified Revenue Cycle Representative (CRCR)
Healthcare Administration Micro-Credential
Personal Information
Revenue Cycle Leader | Specialty Physician Groups, ASCs, and Hospital RCM | RCM Workflow and Process Automation | M.S. AI Business Strategy (in process)
Timeline
Eastern University - Master of Science, AI Business Strategy
10.2026 - 05.2029Read more
Western Governors University - Bachelor of Science, Healthcare Administration
08.2025 - 08.2026Read more
Manager, Revenue Cycle Operations
R1 RCM
05.2022 - CurrentRead more
Patient Access & Analytics Operations Manager
R1 RCM
05.2018 - 05.2022Read more
Billing, Charge Entry, and EDI Data Analyst
JourneyPure
05.2017 - 12.2017Read more
Manager of Patient AR and Customer Service
Covenant Surgical Partners
11.2013 - 04.2017Read more
AR Follow-Up and Cash Management
Tennessee Orthopedic Alliance
05.2012 - 11.2013Read more
EDI Technical Research Analyst
Change Healthcare
01.2000 - 07.2005Read more