Provider Resources, Inc.
Pamela J. Shickles, JD, PMP, possesses extensive experience in compliance and risk management within the healthcare and insurance sectors. Currently serving as Program Manager at Provider Resources, Inc. since May 2014, Pamela oversees the Appeals Review for the Centers for Medicare & Medicaid Services’ Coverage Gap Discount Program, ensuring program compliance and providing expertise in appeals processes. Prior roles at Humana included Risk Advisor in Claims Operations where Pamela ensured Medicare Advantage claims compliance, as well as managerial positions focused on payment policy and contract services. Pamela’s earlier career involved roles as Senior Staff Attorney at Sharps & Associates and Insurance Defense Attorney at Ward, Tyler & Scott, in addition to serving as a Deputy Prosecuting Attorney at the Clark County Prosecutor's Office. Pamela holds a J.D. from Indiana University Robert H. McKinney School of Law and a BS in Business Management from Indiana University Southeast.
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Provider Resources, Inc.
Provider Resources, Inc. (PRI) offers the federal healthcare space expert services in medical review and program integrity measures, education and training, healthcare quality initiatives, and policy & regulatory expertise - all aimed at instilling integrity into the healthcare system. We are always seeking board certified physicians to join our PRI Physicians Consortium for Clinical Integrity. Mission Statement Provider Resources, Inc., recognizing the complexity of healthcare, is dedicated to supporting the healthcare community with compliance and integrity issues through education and efficient, innovative processes. Value Statement In pursuit of our mission, we must always be mindful of the values each and every one of us must impart as individuals and together are the spirit of Provider Resources, Inc. Our values must be soundly based upon the principles of honesty, sincerity, kindness, goodness, loyalty, patience, understanding… integrity.