Happenings
Division 93 Spotlights Top Performing Associates
Associate of the Month — July
Beverly Davis
With an impressive 27-year tenure at Palmetto GBA, Beverly Davis exemplifies dedication and excellence. Recently, she was asked to to help make provider and supplier education calls and she completed 150 calls in one month. Beverly completed this additional responsibility alongside her primary duties as a medical reviewer III, reviewing claims and averaging 40 education calls weekly. Her contributions significantly exceed departmental quality and quantity goals This noteworthy achievement highlights her exceptional productivity and commitment to maintaining high standards of customer service. Her outstanding performance earned her the Division 93 third quarter July Associate of the Month award.
Associate of the Month — August
John Sessions
John Sessions has been a dedicated member of the Augusta Document Control team for the past 12 years. Known for his hard work, responsibility, loyalty, and positive attitude, John regularly handles duties beyond his role as a document preparation clerk. John’s meticulous attention to quality is reflected by his external Document Control Center quality score of 99.95% and an individual quality score of 99.59% for the review period. His strong working relationships across multiple lines of business and willingness to assist in other areas highlight his versatility and team spirit. John’s infectious positive attitude makes him a valued asset of Palmetto GBA and worthy of the August Associate of the Month award.
Associate of the Month — September
Valerie Day
Valerie Day, a senior quality analyst for Provider Enrollment, is the Q3 September Associate of the Month. Her exceptional skills in provider file maintenance and extensive knowledge have been a great benefit to both external customers and internal stakeholders. Her deep understanding of the Provider Contact Center’s operations helps her effectively address customer needs, particularly regarding claims. Her dedication to superior customer service has earned her widespread acclaim and set a high standard for service excellence that inspires her colleagues. Valerie is also quite skilled in resolving provider issues and her proactive engagement with major providers ensure that critical records remain accurate and up to date. Her comprehensive knowledge combined with her empathetic approach make her an invaluable asset to Palmetto GBA.
Coach of the Quarter
Susan Coyle
On an average day, Susan Coyle, a supervisor in Medical Review, is instrumental in guiding the skills, knowledge and talent development of her team, ensuring each associate is equipped to excel in their roles. In late September, amidst the aftermath of the catastrophic Hurricane Helene, Susan was so much more than a supervisor to her team in Augusta, Georgia. Despite facing her own challenges, she reached out to her staff to check on their safety and well-being. She coordinated with company leadership to provide those in need with essential resources such as hotel accommodations, water and gift cards for essentials. Her efforts turned a dire situation into one of community support and resilience.
Susan’s dedication and extraordinary efforts during this historic storm has earned her the Coach of the Quarter award. Her commitment to her colleagues and her exceptional leadership during a time of crisis are commendable.
Team of the Quarter
Augusta Hurricane Recovery Dream Team
Team members: Helen Brown, Valerie Day, Octavia Gates-Huff and Melissa Mayson
Two days after Hurricane Helene knocked out utilities in the Augusta office, some communication was restored, so managers initiated recovery efforts to ensure customer service continuity. They asked for volunteers to temporarily relocate to the Columbia office where utilities were fully functional. Helen Brown, Valerie Day, Octavia Gates-Huff and Melissa Mayson stepped up. This “Dream Team” of experienced associates had the broad knowledge, skills and ability to complete vital operations. They ensured that time-sensitive tasks were completed, and performance metrics were maintained and exceptional. Their outstanding performance earned them the division Q3 Team of the Quarter award.
Process Improvement of the Quarter
Cross-Training Claims Workload Rotation
The Process Improvement of the Quarter introduces a two-week workload rotation by claim-type for registered nurses who work as medical reviewers. As a result of this improvement, all medical reviewers will be trained and certified on all claim types, enabling them to handle any claim. This systematic rotation every two weeks will help reviewers expand their knowledge base and ensure they stay current by routinely working on all claim types.
Medical reviewers are required to complete comprehensive cross-training and certification to work on certain claim types. Retaining skills through regular practice eliminates the need for repeated training, saving time for trainers. In addition to improving accuracy and efficiency, the rotation adds varied challenges and an enhanced knowledge base for reviewers, which reduces burnout and turnover.
