Happenings
Division 93 Q1 Award-Winning Associates
Coach of the Quarter
Rochell Smith
Customer service coordinator Rochell Smith is Division 93’s Coach of the Quarter for her exceptional dedication, flexibility and leadership. A vital resource and a pillar of support, Rochell shares knowledge with others clearly and patiently. Always willing to step up, Rochell has volunteered several times to lead new hire training during the trainer’s absence. Her positivity, reliability, team-first attitude and commitment to open communication have strengthened her team and elevated their level of customer care. Whether she is mentoring a peer, resolving a difficult issue, working on a project or stepping in where needed, Rochell delivers superior service and leadership every step of the way.
Associate of the Month — January
Angela DeBlasio
Angela DeBlasio, a medical reviewer III for the Railroad Retirement Board Specialty Medicare Administrator Contractor (RRB SMAC), has been named January's Associate of the Month. Angela consistently steps up to assist others, sharing her knowledge and expertise whenever needed. She played a crucial role in training a new member of the Targeted Probe and Educate team, serving as a valuable resource for them. Angela also shared her expertise in Evaluation and Management claims, offering the trainer insights during the group's learning sessions. As a lead reviewer on complex claims, Angela consistently delivers support and ongoing education to her colleagues. Her productivity and quality far exceed expectations, and she willingly helps less experienced team members while sharing her thoughts on process improvements.
Associate of the Month — February
Blair Wooten
Described as approachable, personable, intelligent, kind and humble, Blair Wooten is also Associate of the Month for February. A medical reviewer III for the RRB SMAC, Blair takes the time to help less experienced colleagues. She is quick to respond with evidence-based education and resources. If she doesn’t know the answer, she will help find it. She is a true team player.
Associate of the Month — March
Mary Malaguti
Mary Malaguti is a medical reviewer III in the Appeals Department and Associate of the Month for March. In addition to exceeding her quality objectives and averaging 100 percent on all her quality reviews during the two years she has been with Palmetto GBA, she willingly mentors and guides other nurses. She also fosters a culture of care, respect, encouragement and is a valued teammate. Mary has also contributed to two process improvement initiatives, further demonstrating her commitment to excellence.
Team of the Quarter
Benefit Integrity Team
Team members: Van Dixon, Tammy Keel, Ricky Newton, Donna Phelan, Janet Pleiman and Debra Watson
The Benefit Integrity (BI) team was honored as Team of the Quarter for their outstanding efforts in safeguarding the Medicare Trust Fund. In the first quarter, they initiated multiple investigations and reviewed cases, encompassing more than 5,000 claims. As a result, they identified more than $580,000 in overpayments, which they promptly sought to recover from providers. The BI team also followed up on cases involving providers who had received payments despite having their privileges revoked, resulting in the recovery of more than $47,000. During this period, they also helped verify if specific providers were under formal reviews and handled 11 requests from law enforcement agencies, most of which were completed within 24 hours.
Process Improvement of the Quarter
Medicare Statistical Analysis Department Count Sheet
Team members: Van Dixon, Tammy Keel, Ricky Newton, Donna Phelan and Debra Watson
Every month, the BI team analyzes claim histories of healthcare providers to check for unusual billing patterns and ensure no claims are paid after providers are disqualified or sanctioned. The team also performs additional reviews if law enforcement requests them. Before the improvement, each team member kept a list of the claims they analyzed, which was later tallied for the monthly report sent to the Medicare Statistical Analysis Department. Through the recent process improvement initiative, the team introduced a centralized spreadsheet for team members to record their counts, significantly streamlining the workflow and enhancing efficiency. This initiative earned the BI team the Process Improvement of the Quarter award in recognition of their efforts.
