Kelly joins Pinnacle as an Executive Consultant of Pinnacle Enterprise Risk Consulting Services, bringing expertise in internal audit, compliance program development, implementation and assessments, billing compliance, investigation/defense support and risk mitigation services. Kelly has over 30 years of healthcare operations experience and has served in various management, compliance and internal audit roles. She is knowledgeable in revenue cycle processes, billing and reimbursement for hospitals, physicians, reference laboratories, retail pharmacy, hospice, homecare, skilled nursing facilities and ambulance.
While working at an integrated health system, Kelly was as a registered nurse specializing in cardiology and neurology and also held positions as quality management specialist, utilization management specialist, internal audit director, patient financial services director, and system implementation director. As internal audit director and managing director in a national consulting firm, she was responsible for operational, financial, integrated and billing compliance audits for hospitals, clinics, homecare, hospice, durable medical equipment, ambulance, skilled nursing facilities and reference laboratory services.
Kelly’s strong ability to anticipate risk and regulatory issues was critical in developing successful mitigation strategies for a $300 million electronic medical record (EMR) implementation. She served as the compliance director overseeing the EMR implementation while the organization was under a corporate integrity agreement as well as chargemaster director during the design and implementation of a single chargemaster and consolidated fee schedules.
Kelly has proven success in designing and implementing strategic initiatives focused on improving operational efficiency, maximizing revenue, and reducing cost. She is skilled in process improvement, leading cross functional teams, managing systems, facilitating change, and has extensive experience identifying strategic opportunities, developing plans and implementing improvements in a short time frame.
- What You Need to Know to Audit and Monitor the Revenue Cycle, HCCA's 23rd Annual Compliance Institute, April 9, 2019