Happenings
Shared Services Division Celebrates Outstanding Associates
Coach of the Quarter
Melissa Murren
Melissa Murren is known for being approachable and having great listening skills. A supervisor in the Jurisdiction M Home Health and Hospice Appeals Department, she is the Q1 Coach of the Quarter because of her positive and encouraging management style. Melissa is quick to respond to questions or concerns and is readily available and willing to help her team achieve their goals. She is particularly successful as a coach because she is able to answer questions and share her knowledge with her teammates while making them feel they are an important and useful part of her team. During monthly team meetings she keeps everyone current and recognizes associates who have made a difference or a significant contribution. She encourages questions and makes sure that everyone has the tools they need and feel empowered to succeed. A strong advocate of process improvement, Melissa helps associates think through their ideas and encourages them to move forward. Melissa is a great coach and teammate.
Associate of the Month – January
Jillian Lees
Jillian Lees, a medical affairs coordinator for the Molecular Diagnostics (MolDX) Program, is the Shared Services Division January Associate of the Month because of her outstanding performance completing the work of a coordinator who had been out on leave for six months. Despite the heavy workload, Jillian remained efficient, organized, professional and conscientious—all without complaint. Typically, she completes assignments well in advance of deadlines to ensure the team meets quality objectives. Perhaps most significant, providers offered positive feedback on the quality and speed of Jillian’s work.
Associate of the Month – February
Mike Sudduth
As an e-learning designer/developer, Mike Sudduth transforms ideas into dynamic designs. He is the February Associate of the Month for delivering more than what the Center for Medicare & Medicaid Services (CMS) liason requested—a design mock-up to share with her website designers. Mike was asked to create a design of his team’s proposed changes to a tool on the CMS website. He worked with the project lead, discussed visual treatments, listened to suggestions and made changes to align with customer and team requests. Mike delivered not only mockups but also a diagram of the team’s vision for the webpage interactivity because he thought it would provide a clearer explanation. The CMS customer was pleased with the mockups and impressed by the diagram. Mike also helped lead the discussions during the meeting with the customer. He also helped his team by building a design protocol database, updating compliance instructions and helping to train a new designer.
Associate of the Month – March
Rebecca Wagner
The March Associate of the Month is Rebecca Wagner, a Jurisdiction M appeals specialist in the Part B Appeals Department. Praised for her knowledge base and outstanding communication skills, Rebecca often takes extra steps to ensure claims are processed accurately. She helps others navigate technology issues and offers solutions to problems that go well beyond her job duties. In one instance, Rebecca suggested a temporary fix to a system problem and guided staff through the steps so they could continue processing claims while technicians worked on a permanent solution.
Rebecca maintains impressive metrics, consistently meeting or exceeding performance standards. She is a detail-oriented, analytical thinker and excels in both decision accuracy and overall quality while meeting or exceeding productivity standards. A team player, Rebecca responds to coworkers emails and calls promptly to help them process claims quickly and correctly to meet customer expectations and team goals.
Process Improvement of the Quarter
Big Box Reopening Mill Script
Team members: Lynne Culler, Jennifer Foit, Rae Mahaney, Vontrae Roach
The Jurisdictions J and M Part B Appeals Department received a large volume of appeals requests related to overpayments for services billed with the incorrect place of service. Team members Lynne Culler, Jennifer Foit, Rae Mahaney and Vontrae Roach determined that the most efficient way to process them was by running them through the automated claims processing system, nicknamed the Mill. They worked with the Mill team to design and implement a script to process the large batch of appeals. The Mill can process 1,800 claims an hour, significantly more than the 12 a specialist can adjust and close in an hour. Since implementation, 9,814 claims with an incorrect place of service have been adjusted and closed with this automated process. Named Shared Services Process Improvement of the Quarter, it reduced clerical errors to zero and the total processing time by 818 hours.
Team of the Quarter
Medicare Secondary Payer Prepay Claims Team
Team members: LoveaLee Blevins, Tathiane Flint, Vonda Holbrook, Linda Howard, Lisa Marshall, Becky Meade, Tina Patterson, Canderia Peterson, Linnie Taylor and Whitney Varnadoe
The Medicare Secondary Payer (MSP) prepay claims team in the Part B Claims Processing Department is a solid performer but was recognized as Team of the Quarter for their response to receiving an extremely large volume of suspended claims. When the Provider Contact Center told the team that they were seeing a significant increase in inquiries for denied MSP prepay claims, the team jumped into action, researching claims and working to identify the source of the problem. Once the issue was identified and corrected, the MSP prepay claims workload increased dramatically. The team rose to the challenge and the department support staff members assisted with claims processing. To increase efficiency, the team modified the workflow ensuring they maintained timeliness parameters and completed the work on time.
