Pamela Ellis has over 20 years of experience in healthcare revenue cycle management, patient access, and EMR/EPM implementation. She has held various leadership roles at healthcare organizations and consulting firms, managing teams and improving revenue cycle processes through initiatives like denial recovery, training development, and system implementations. Her background includes experience with revenue cycle assessments, interim management, and strategic planning.
1. Pamela Ellis
10722 Ibis Reserve Circle West Palm Beach FL 33412 Phone: (C) 313-550-6436 plsdesign54@yahoo.com
Senior Leader in Revenue Cycle,Patient Access,and Implementation
EMR/EPM
Experienced healthcare professional with skills in proven turnaround operational challenges
with team building, system go live & implementation, denial recovery, revenue training
development, patient and cash flow improvement. Proven business development with hands
on assessing training, planning and implementing and revenue cycle processes application
systems. Developing strategic policies and procedures for long term goals and processes by
creating those processes QAPI/Lean Six Sigma Team.
Professional Experience
Trustbridge Health 2015 - Present
Director Revenue & Billing
Hospice facilities with physician plans and mid-level providers, supporting over 150 nursing homes,
Palliative Care and hospital services.
Manage, administer, develop and maintain key metrics to facilitate continuous improvement in,
financial counseling, payment posting, insurance verification/authorizations, insurance and
patient billing, collections, refunds and unapplied credit.
Establish and implement and develop instructional programs focused on maximizing collections to
meet or exceed standards, minimizing patient account write offs.
Work with Operations on the proper procedures for the front office staff including medical
records
Manage a team of coders and assist to implement coding guidelines, clinical staff training and
proper processes for billing.
Oversee documentation compliance and internal documentation audits and provide feedback to
Compliance for required changes/education.
Comply with all internal controls and governmental regulatory requirements for billing
Assist with notification and processes for all department staff that work within the practice
management software
Develop best practices to streamline the revenue cycle and establish protocols and policies that
minimize risk.
Assist with selection and implementation of an EMR and act as the coordinator to insure coding
guidelines and requirements are met and billing process and interface is seamless and efficient
Monitor payer billing guidelines through federal guidelines of federal and state policies.
Manage department staff and coordinate efforts within the company, to develop best practice for
all areas as they pertain to the revenue cycle.
Assist to negotiate and administer contractual relationships and ongoing meetings with insurance
carriers.
Manage and oversee the clearinghouse and associated contract
Implement appropriate billing software edits with IT, for efficient claim submission and faster
payment turnaround.
Assist to administer and maintain current processes, policies and procedures.
2. Writing job description, identifying appropriate candidates, hiring, training oversight and work
performance management for the corporate business office revenue cycle team.
CLMS Laboratories-Physician Billing 2014 - 2015
Consulting Manager Revenue Cycle- Contracted
A national, full-service revenue cycle, denied claims resolution and performance improvement; with
providing Development and training for the revenue cycle to staff and to physicians of the firm. The
approach focuses on the simultaneous goals of resolving existing inventories of denied claims and
improving organizational processes by identifying root causes and recommending performance
improvement.
Comprehensive review and assessment of billing and collections, denials/appeals and deficiencies
within the revenue cycle processes.
Comprehensive review and restructuring of front end work flow, updating policy and procedures.
Communicate with all levels/stakeholders by developing ongoing meetings for all changes within
Revenue Cycle.
Physician/Laboratory Credentialing
Ability to identify opportunities for recovery and resolution, while implementing revenue cycle
changes/policies.
Interview, motivate and train staff. Monitoring of all productivity to ensure quality and goals are
achieved that have been set to move clients forward in a strategic direction.
Collaborate with IT to ensure systems are performing at the maximum levels throughout Patient
Financial Services and all other departments.
QA of accounts to ensure billing process are appropriate practices and in compliance with federal
and payer guidelines and regulatory demands.
Credentialing all carriers for all out of state insurances. Loading the payer’s fee schedules into
billing software.
Conifer Health Solutions – Dallas, TX 2013 to 2014
Contracted Revenue Cycle Client Delivery
Manager of Revenue Cycle
A national, full-service revenue cycle, denied claims resolution and performance improvement firm. The
approach focuses on the simultaneous goals of resolving existing inventories of denied claims and
improving organizational processes by identifying root causes and recommending performance
improvement.
Comprehensive review and assessment of billing and collections, denials/appeals and deficiencies
within the revenue cycle processes for academic facilities, acute care facilities and physician
practices.
Strong techniques in assessing patient access, billing, patient accounting, work flow, eligibility
and the reporting systems within revenue cycle.
The ability to produce reports for analysis of AR/billing performance and reimbursement to
present to C Suite Executives.
ICD-10 testing and workflow modification for revenue cycle. Development of test files for
testing; within a test environment.
3. Comprehensive review of chargemaster from patient access view and ongoing documenting of
findings.
Communicate with all levels/stakeholders by developing ongoing meetings and or committees for
all strategic changes within Patient Financial Services and Revenue Cycle in moving forward.
Ability to identify opportunities for recovery and resolution, while implementing revenue cycle
changes/policies.
Interview, motivate and train staff. Monitoring of all productivity to ensure quality and goals are
achieved that have been set to move clients in a positive direction.
Collaborate with financial counseling and patient access to develop processes for POS collections.
Collaborate with IT to ensure systems are performing at the maximum levels throughout Patient
Financial Services and all other departments through the cut over to Cerner registration.
QA of accounts to ensure billing process are appropriate practices and in compliance with federal
and payer guidelines.
Pierce Monroe & Associates
Contracted Consulting
HBS -Dearborn, MI 2012 to 2013
Director of Revenue Cycle (Interim/Contracted)
A national, full-service denied claims resolution and performance improvement consulting firm. The
approach focuses on the simultaneous goals of resolving existing inventories of denied claims and
improving organizational processes by identifying root causes and recommending performance
improvement.
Completed a comprehensive review of denials (Acute Care facilities) for appeals to ensure
account deficiencies and timely billings resolutions which increased revenues 6.5 million within
3 months.
Identified and recommended quality and performance improvement/reporting to revenue
cycle and patient access departments for teaching/academic facility.
Monitor charge entry, billing, cash posting, follow up and produce dashboard reporting.
Analyzed data for tracking and trending of denials to structure team goals to resolve all
denials and set long range direction and capacity plans by using best practices.
Assessment of NextGen Systems, customization and upgrades for maximum performance.
Soarian Financials cleanup project to transition to Epic Systems.
Coordinate revenue cycle initiatives and Go Live system implementation.
Assessment of departments process flow NASCO/BCR. Re-allocating staffing due to merging
of departments.
Contracted Position
Accenture, - Chicago, Ill 2010-2012
Consultant
A global management consulting, technology service and outsourcing company helping clients
become high-performance businesses. Specializing in revenue cycle, patient access, systems
conversions, ICD-10 assessments and interim management for acute care hospitals, academic
facilities and physician groups.
Engaged in organizing and implementing system upgrades for billing and patient access area;
and developing value stream mapping.
Engaged with process development in change management and assessment of ICD-10
4. workflows.
Engaged in ICD-10-PCS with customer on support training, testing and interface modifications
requirements.
Engaged in ICD-10-PCS contingency plan for dual application use and support, timelines, cost
estimations and maintenance fees.
Engaged with testing team for implementation of process flows for upgrades and systems
integration.
Assessed denials and tracked deficiencies within revenue cycle and patient access
departments.
Coordinating UAT testing activities for projects with systems implementation.
Assist in data gathering for Soarian Financial System upgrades for clinical and financial
departments.
Assessment/Integration of NextGen and Cerner system with customization and upgrades for
maximum performance.
Coordinate with client revenue cycle initiatives.
Lay-off of 7% of workforce
Wayne State University Physician Group/DMC- Detroit, MI 2009-2010
Detroit, MI
Manager Financial Counseling/Patient Access
Academic facility with physician practice plans comprised of 1000 + physicians and mid-level providers
with over 150 clinics with all specialties.
Increased cash collections (patient pay) by 6% per month and reducing days in AR by deploying
onsite billing staff in clinic settings by creating training and development materials for all areas.
Provided direction and leadership to 132 professionals involved in verifications, registration,
financial counseling, collections, charge entry and billing.
Participated and provided departmental education on billing, system upgrade with training, point
of service collections, call center, denial trending/tracking and reevaluation of charge master.
Increased monthly insurance billing by implementing a financial counseling department to process
Medicaid applications/approvals for insurance coverage.
Participated with DMC patient initiatives programs to ensure smooth transition/roll out and
education in billing processes.
Review dashboard and revenue cycle reports with the providers and CFO.
Maximize use of the EPM system (IDX-GE, NextGen)
Physician credentialing/re-credentialing.
Provided direction and planning for migration of centralized scheduling department for outpatient
and clinic facilities.
Merger of out-of-state facilities.
Perot Systems – PLANO, TX 2006 -2008
Consultant
A global management consulting, technology service and outsourcing company helping clients
become high-performance businesses. Specializing in revenue cycle, HIM, patient access, systems
conversions, Assessments and interim management for acute care hospitals, academic facilities and
physician groups.
Increased authorization by 35% by creating processes and ongoing revenue development
training with third party payers.
Revenue increase within the surgery department of $400,000 monthly by process
improvement and training within charge capture.
Increased revenue by 950 visits by reviewing unbilled physician service reports.
5. Provided objected analysis review of revenue cycle and front end process to deliver industry
standards.
Involvement with EMR/EPM implementation/training and development of materials for classes
for system upgrades.
HIM chart auditing, review and work with staff/departments on DFNB reports.
Update Project tools with completed task; Add and assign task, as deemed necessary.
Strategic Planning for all revenue cycle goals.
Lay-off of 4,000 Employees
Adjunct Instructor 2001-2013
Baker College
Davenport University
University of Phoenix
Dorsey Schools
Education
Degrees
PHD- TBD Public Administration-Public Policy & Strategies- Capella University, Minneapolis, MN
MSA- Information System Resource Management – Central Michigan University, Mt. Pleasant, MI
Public Administration Certificate - Central Michigan University, Mt. Pleasant, MI
BS – Organizational Administration – Central Michigan University, Mt. Pleasant, MI
Certifications
Effective Facilitator, Leadership Strategies, Troy, MI
Lean Six Sigma Black Belt, Lawrence Technical University, Southfield, MI
Lean Six Sigma Greenbelt, Lawrence Technical University, Southfield, MI
HIT PRO, AHIMA 12/2012
System Application
eCW, Nextgen, HCHB, ZirMed, Emdeon, Soarian Financials, Medisoft, CIRIUS, EPremis, Cerner, Cerner
PowerChart, Scheduling, IDX, Siemens, McKesson, Microsoft Office