Coach of the Quarter - Amy Bailey

Amy Bailey, a Claims Operations Supervisor, exemplifies what is needed to be a leader. With over 19 years at Palmetto GBA, she leads her team to successfully perform increasing work functions associated with the restarting of post-payment medical review. This work includes producing requests for additional documentation, printing, and mailing, manually tracking extension requests as well as other activities to ensure completion of Jurisdictions M and J workloads. Amy’s tireless efforts empowered her team to go the extra mile. Her efforts and leadership demonstrate what being a Palmetto GBA leader is all about.

Process Improvement of the Quarter - ACE Messaging 

When processing a Medicare claim, additional documentation from the provider may be needed. To assist in preventing denials for non-receipt of medical records, Palmetto GBA clinicians previously made a call to the provider to remind them of a pending additional documentation request. The medical review team wanted to make this process more efficient. With the help of the Palmetto GBA Advanced Communications Engine (ACE) team, the medical review team developed an alternative solution. Implemented in March 2021,  providers who have not responded now receive an ACE message when billing. This message informs the provider that there is a pending request that needs to be reviewed. This new process eliminates the need for phone calls, which in turn saves time and money.

Associates of the Month

April - Suze Johnson

Suze Johnson, a Customer Service Advocate II, has been with the company for over 13 years.  She is a team player who gives her best every day. The providers she works with have acknowledged her as someone who takes her time to understand all the information so that she can best assist them with their questions. Suze is a hardworking and passionate employee who not only works to meet her own goals but also assists others in meeting their deadlines and goals as well.

June - Martha Roberts

Martha Roberts, a Customer Service Advocate II, is a sincere, dedicated, and hard-working employee for the Provider Contact Center (PCC). She has been with the PCC since 2018 and with the telephone reopening team for nearly eighteen months. Martha displays a willingness to learn and teach others. She possesses diverse skills and has adapted to answering reopening calls and jumping back in on the PCC line to assist with calls as well. She has a strong passion for leadership and her analytical skills are highly successful when problem-solving. According to her team, "Martha is always a team player and with her on our team, the PCC will  be successful."