Coach of the Quarter – Alyssa Lewis

Alyssa Lewis, an Auditor III, has been a valuable member of the team for over five years. Alyssa takes ownership of the growth and development of her staff. She takes time to explain processes and procedures, ensuring that associates not only complete tasks but also understand the reasoning behind them. Alyssa regularly mentors associates and assists with any questions from both staff and providers. She was part of a group responsible for a level two review of the workload, resulting in a passing Quality Assurance Surveillance Plans (QASP) score for the S-10 workload. She champions change and suggests modifications to make overall processes more efficient and accurate. Alyssa volunteers to test updated templates to ensure they function correctly and continuously looks for ways to improve processes. We congratulate Alyssa on being named Division 28’s Coach of the Quarter for her exceptional leadership.

Team of the Quarter – Medical Review Data Strategy Support Team

The Data Strategy team is comprised of clinicians and operational analysts who work together to achieve the goals of the Targeted Probe and Educate (TPE) initiative. The team meets weekly to discuss tasks and strategize solutions. They are quick to aid other areas if needed. Recently, the team helped the claims operations team with the Home Health Oasis workload, and within a week, they completed their assignment while still conducting their daily duties. The Data Strategy team surpassed expectations by meeting all timeliness reports with 100% accuracy. The clinical team responds to provider inquiries and tickets transferred from the Provider Contact Center (PCC) and resolves them within 24 hours of receipt. The team also contributed to the QASP initiative and achieved a 100% for the Centers for Medicare & Medicaid Services (CMS) QASP score for the past year. Additionally, there were no findings on any of the desk audits conducted in 2023. This team's hard work and commitment to quality and efficiency is why we are naming them our Division 28 Team of the Quarter. Congratulations.

Team Members: Sheila Bell, Terri Bozard, Rashawne Coates, Kayce Coleman-Adkins, Mary Evans, Cheryl Evans, Kareem Green, Mary Hamill, Janet Jackson, Denise Phillips, Molly Reynolds, Shaunice Richardson, Shavonne Samuel, Richard Sowell, Chantel Warren, Leslie Wells, Lauren Weston, and Jennifer Williamson

Process Improvement of the Quarter – CERT TIP Letter Attachment-Reduction in Pages

After the Comprehensive Error Rate Testing (CERT) contractor decides to deny a claim based on coverage or billing issues, providers will receive an individual CERT Teaching and Instruction for Providers (TIP) letter for each claim denial. This letter has several purposes, including enhancing the provider's knowledge of the CERT program, providing education specific to the denial reason, suggesting ways to prevent similar denials, providing information regarding the appeals process, and offering guidance on accessing the Palmetto GBA website. Additionally, the TIP letter includes information about the C3HUB website and how to use the Claim Status Search tool to check the status of a claim under CERT review. Initially, the TIP letters consisted of 14 pages total, with 12 of the pages including detailed information about the CERT program and eServices that could be found on Palmetto GBA’s website. The team responsible for the TIP letters was able to reduce the number of pages in the attachment, resulting in a reduction from 14 pages to three pages. This reduction saved a significant amount of time and paper in processing each of these letters. Congratulations to this team for their efforts to increase efficiency.

Team Members: Ashley Baker, Asahia Cartledge, April Gause, Jennifer Greer, Kalena Hammock, Selena Haskins, James Kirk, Margaret Martin, Bonnie Miller, John Sessions, Kellie Warren, and Jennifer Williams

Associate of the Month (April) – Shavonne Samuel

Senior Operation Analyst, Shavonne Samuel, has been a valuable member of the team for nearly four years. Shavonne readily assists her colleagues with their daily inquiries about Part A and Railroad Retirement Board (RRB) processes and procedures. She has even taken the initiative to train two new team members and create helpful tutorials to aid them in their roles. Shavonne has consistently exceeded expectations, displaying accountability, integrity, and a willingness to go the extra mile. Managers in her area praise her for her dedication and her eagerness to learn about various management roles. Congratulations to Shavonne for being named Division 28’s Associate of the Month.

Associate of the Month (May) - Sean Janson

Sean Johnson, a hard-working Auditor I is an indispensable member of his team. His job requires him to analyze problems with deep focus, think critically, and remain vigilant. Sean is a true professional, always completing his projects on time and ensuring that the overall quality of work is never compromised. He communicates effectively and promptly, always expressing his feedback and suggestions politely. His teamwork skills are exceptional, and he always goes the extra mile to ensure the success of the team. We are proud to name Sean as Division 28’s Associate of the Month for his dedication to producing the highest quality work possible. Congratulations, Sean!

Associate of the Month (June) – Ryan Stapler

Congratulations to Ryan Stapler, a Senior Provider Enrollment Analyst, for being named our Division 28 Associate of the Month. Ryan consistently provides outstanding customer service, whether it's with Palmetto GBA providers, contacts, authorized or delegated officials, or his co-workers Ryan also contributes to his team’s monthly department meetings by creating and presenting training slides. He handles his workload with ease, never complains, and is always willing to help others. We appreciate his hard work and dedication.