Professional Overview
Matthew Mikulski holds senior leadership roles at Zelis, a healthcare technology company specializing in provider revenue cycle management, claims pricing, and network solutions. His current titles include Senior Vice President (SVP), Pricing Solutions, and General Manager, Network Solutions, and Out of Network Services. Mikulski’s expertise lies primarily in claims pricing, healthcare cost management, and network solutions tailored for optimizing provider and payer interactions within the healthcare ecosystem.
Role and Responsibilities
At Zelis, Mikulski spearheads pricing solutions and network strategy initiatives. He is instrumental in navigating complex regulatory environments, including the impact and adaptation to NSA (No Surprises Act) regulations on claims pricing, as evidenced by his participation in expert panels and podcast discussions dated October 2024. His leadership focuses on innovating market-based pricing models that can be tailored dynamically according to specific payer plans, demonstrating a deep understanding of plan-specific healthcare economics.
Mikulski is also a key figure in developing and enhancing digital platforms that improve patient access to high-quality in-network dental providers, collaborating with healthcare partners such as Intelibly (announcement in March 2025). This initiative underscores his role in expanding Zelis’ network capabilities focused on accessibility and patient engagement.
Achievements and Industry Recognition
- Healthcare Insurance Innovation Award (2025): Under Mikulski’s leadership, Zelis’ Health Bill Assist technology was recognized by MedTech Breakthrough for innovation in healthcare insurance. This award highlights his strategic role in advancing claims adjudication and billing transparency solutions.
- Active contributor to thought leadership on healthcare policy and regulatory changes, including write-ups and advisory content published by Zelis in mid-2025, reflecting his role in aligning company strategy with evolving healthcare legislative landscapes.
Professional Background and Education
Matthew Mikulski earned his degree from Hartwick College, and he is based in the United States. His LinkedIn profile indicates over 500 professional connections, indicating a substantial network in healthcare and technology sectors.
His prior experience includes operational leadership in network solutions and out-of-network services, emphasizing revenue cycle management and pricing optimization, integrating data-driven, compliance-focused approaches to healthcare claims and billing.
Relevant Industry Insights and Commentary
Mikulski is a recognized voice on the practical implementation of market-based pricing structures. He has articulated the importance of working with partners who possess broad client portfolios and national scope to effectively calibrate pricing models to service payer needs, referencing interviews and expert panels from December 2022 and onward.
He contributes to managing increasing complexities in healthcare billing, positioning Zelis as a forward-facing company committed to compliance and innovation, especially in response to changing federal regulations such as the NSA and related claims pricing mandates.
Contact Data and Location
- Location: United States
Note: Additional contact details are available through professional databases but are omitted to maintain confidentiality in this report.
This profile reflects Matthew Mikulski’s pivotal role at Zelis in leveraging regulatory insights, technology innovation, and market-based pricing to drive the company’s strategic growth in healthcare cost management and claims adjudication solutions.
