Jacqueline Payton, RHIA, CCS, CPMA, CEDC, CEMA, CPPM
Jacqueline Payton is a seasoned healthcare compliance and auditing professional whose career spans more than three decades across nearly every sector of the healthcare industry. After graduating from East Carolina University in 1988, she began her career in physician billing audit and review before expanding into acute care, where she worked extensively with inpatient PPS case mix. Her early experience also includes significant work in rural mental health services in North Carolina, where she played a key role in reviewing Medicaid documentation and ensuring compliance during a critical period before privatization. This foundation gave her a well-rounded understanding of healthcare systems, reimbursement models, and the importance of accurate, ethical documentation. Throughout her career, Jacqueline has continued to build deep expertise across diverse care settings, including nursing homes, hospital systems, and insurance organizations. Her time at Highmark as a dental claims supervisor further strengthened her leadership capabilities, particularly in managing remote teams and fostering employee engagement and retention. She has also held roles in case management, emergency department coding, and compliance auditing, gaining hands-on experience across nearly all specialties. Her ability to adapt to evolving healthcare regulations and systems has made her a trusted expert in coding, auditing, and process improvement. Now based in Gaffney, South Carolina, Jacqueline is focused on leveraging her extensive background in a role centered on leadership, education, and organizational improvement. With a strong commitment to compliance integrity and a passion for training others, she is seeking a permanent, remote position where she can guide teams, enhance operational efficiency, and mentor the next generation of healthcare professionals. Grounded in faith and driven by purpose, Jacqueline is dedicated to making a meaningful and lasting impact in the healthcare field.
• Registered Health Information Administrator (RHIA)
• Certified Coding Specialist (CCS)
• Certified Professional Medical Auditor (CPMA)
• Certified Emergency Department Coder (CEDC)
• Certified Professional Physician Manager (CPPM)
• Certified Evaluation and Management Auditor (CEMA)
• National Association of Baptists Ministerial Training (2 years)
• East Carolina University Bachelor of Science - BS, Health/Health Care Administration/Management
• Strayer University (2019-2020) Jack Welch Leadership in the 21 st Century | Business Communication (Graduate Coursework)
• Secretarty of Young Women's Auxiliary (YWAs), Thickety Mountain Baptist Association, Cherokee County SC
• Secretary of Young Women's Auxiliary (YWAs), Concord Baptist Church, Gaffney SC
• Head of Religious Affairs Committe, National Association for the Advancement of Colored People (NAACP), Cherokee County SC
• Young Women's Auxiliary community outreach (including senior luncheons)
• Youth Bible study teaching
• Liturgical dance instruction for young girls ages 5-18
• Church praise team
• Hospital ministry visitation
What do you attribute your success to?
I attribute my success to gaining experience across multiple healthcare settings and being willing to learn in different environments. Throughout my career, I've worked in almost every type of healthcare facility - from university physician billing to acute care, mental health, nursing homes, dental insurance, and hospital systems. I tell people it's good to have a variety of things, and I feel blessed that God has blessed me to work in different places and be associated with almost every type of specialty. This broad exposure has given me a comprehensive understanding of healthcare operations and compliance requirements. I've also learned the importance of adaptability - I've worked through major changes like the privatization of mental health services, the transition to remote work at Highmark, and the development of new systems like transition from a regular prospective payment system (PPS) model to a Patient Driven Payment Model (PDPM). At this point in my career, I realize that my extensive experience is most valuable when I'm in a position where I can guide teams, improve processes, and ensure things are done correctly, which is why I'm seeking supervisory, managerial, or educational roles.
What’s the best career advice you’ve ever received?
My career has been shaped by a variety of leaders and professional experiences across different healthcare systems. The opportunity to work in diverse roles and environments has played a significant part in my growth, allowing me to expand my knowledge, strengthen my expertise, and develop a well-rounded perspective within the industry.
What advice would you give to young women entering your industry?
I encourage young women entering the healthcare field to seek experience across multiple areas, remain adaptable, and commit to continuous learning throughout their careers. Gaining exposure to different roles, systems, and specialties not only strengthens your skill set but also gives you a deeper understanding of how the industry operates as a whole.
I believe that this broad, well-rounded experience creates a solid foundation for long-term success and positions you for future leadership opportunities. Stay open to growth, embrace change, and never stop learning—those qualities will set you apart and help you make a meaningful impact in healthcare.
What are the biggest challenges or opportunities in your field right now?
Some of the obstacles I see in the workforce is the resistance to change workflows even though the changes will bring about improvements. When processes aren’t functioning as effectively as they could, it naturally highlights opportunities for improvement, and my experience in different work arenas allows a different perspective.
Being a single mother I stayed away from leadership positions until my son was older. Now I realized that I can be most effective in roles where I can contribute to process improvement, support teams, and help guide best practices. Positions in supervision, management, or education allow me to share my experience in a constructive way while helping organizations strengthen compliance and efficiency.
I also see a significant opportunity in healthcare for experienced professionals to step into leadership, education, and training roles.
What values are most important to you in your work and personal life?
God is the center and the head of all my life - that's it. I believe wholeheartedly in serving God with all my heart and with all my soul. In my work, I value doing things correctly and efficiently, which is why I'm drawn to compliance and ensuring processes meet the standards they should. I also deeply value people and relationships. Because I've lost all of my immediate family - everyone I grew up with has passed away - I've learned that I cherish people and don't throw them away. If you get mad with me, I don't care how mad you get with me, I may get mad with you, but I still love you, because I've lost people in my life and I know how valuable people are. I also value integrity and being a representative of Christ in everything I do. For example, when I had an argument with a pizza shop manager, even though I felt I was right, I called her back and apologized because I am a child of God and I represent Christ. The Word of God makes you look in the mirror at yourself, and studying Scripture helps me change the things that are wrong with me. My faith, my service to others through my church and youth ministry, and my commitment to treating people with love and respect are what guide both my work and personal life.