Coach of the Quarter – Torien Ferguson

Torien Ferguson has been with the company for over four years as  as the Part A Home Health and Hospice (HHH) coach for the Provider Call Center (PCC). Her main goal is to equip staff with the necessary skills to navigate, research, and provide accurate information to our providers. Recently, Torien has been using her extensive knowledge of Medicare to coach new hires and prepare them for the production floor. Torien is receptive to feedback and is easy to work with. She does not hesitate to give her opinions or guidance when management introduces new processes. Congratulations Torien, for being named our Associate of the Month!

Team of the Quarter – Jurisdiction J (JJ) Audit, Reopening’s & Appeals

The JJ Audit, Reopenings, and Appeals team recently conducted a supervisory review of the 2018 Supplemental Security Income (SSI) desk reviews. These desk reviews are complex and technical and were all required to be finalized by the end of March 2023. Despite the challenge of the accelerated workload imposed by the Centers for Medicare & Medicaid Services (CMS), the team completed all of the reviews during the quarter. Working closely with providers, they were able to process the workload efficiently and promptly. The supervisory reviewers play a critical role in ensuring the quality of our work in the Audit and Reimbursement team. We extend our congratulations to the JJ Audit, Reopenings, and Appeals team for their outstanding work.

Team Members: Marcia Austin, Tamesha Bryant, Chip Cantrell, Meredith Cate, Helen Chamberlain, Darlen Cox, Angie Faulds, Allison Hoar, Jessica Jackson, Marquette Johnson, Rick McClain, Tremayne Nunley, Mari-Aliscia Nunnally, Vonetta Prince, Cheryl Puckett, Brittany Sandifer, Debbie Scott, Ebony Starr-Batie, Rachel Till, and Sharon Wood

Process Improvement of the Quarter – Productivity Measuring and Tracking

Previously, the Jurisdiction J (JJ) Audit Appeals and Reopening process lacked the ability to accurately track hours worked by provider number (PTAN), fiscal year-end date (FYE), and reopening ID (RO ID). While the excel biweekly timesheet captured PTAN and FYE, it did not include the RO ID. As a result, the information from all auditors' biweekly timesheets was uploaded to a database, which led to multiple ROs being associated with the same PTAN and FYE but for different auditors and reviewers.

To improve the post-processing system, a template for an excel productivity tracker was developed. The completions are categorized by JJ and Jurisdiction M (JM) contract reopenings and Audit Department desk reviews. Additionally, the tracker reports on units in progress for each month, separated by JJ and JM contract.

The excel biweekly timesheet reopening time codes have been updated in a way that allows the reopenings department to report productivity more accurately. With this information, the department can estimate future productivity goals for auditors and reviewers. Additionally, the Productivity Tracker template will help auditors and reviewers keep track of their progress toward meeting their productivity goals. Congratulations!

Team Members: Tammy Holmes, Rick McLain, and Deborah Scott

Associate of the Month (January) - Brittany Sandifer

Brittany Sandifer, an Auditor III, is a dedicated team player who consistently exceeds her quality goals and promotes excellence in the organization. She has taken on additional projects outside of her auditing work to further her growth and contributions to the team. Brittany also participates in workgroups for process improvements and recently mentored a new hire, helping her quickly adapt to Medicare auditing. We appreciate Brittany's hard work and commitment to efficiency and quality in the organization. Congratulations!

Associate of the Month (February) - Maryjane Aitchison

Maryjane Aitchison is a vital member of Palmetto GBA's Telephone Reopening Team (TRO). As a Customer Service Advocate (CSA) II, Maryjane has been supporting the team for over three years. She communicates weekly with management and the Part B training coordinator, helping team members who may need assistance with invalid reopening requests. Maryjane is an exceptional leader, always available to guide and answer questions regarding TRO. Her analytical skills allow her to research and devise a plan to resolve issues for management, CSAs, and providers. Maryjane consistently promotes quality by excelling in her work and exceeding the department's quality standards. We are thrilled to announce Maryjane as our Associate of the Month for her outstanding quality of work and her dedication to being the best.

Associate of the Month (March) - Cecil Morrell

Cecil Morrell is a dedicated and hardworking Customer Service Advocate II who prioritizes quality customer service. He works closely with his teammates to ensure that they understand the proper verbiage and communication practices. Cecil demonstrates professionalism in all of his interactions, whether with internal team members or external customers and is committed to the success of the company and his team. Recently, he received recognition for maintaining 100% quality assurance (QA) scores in privacy, knowledge, and customer skills. We congratulate Cecil for being named our Associate of the Month for his outstanding work and drive to be the best.