Happenings
Shared Services Division Honors Fourth Quarter Top Performers
Coach of the Quarter
April Jackson, manager of utilization management for Jurisdiction J Appeals, has been named Coach of the Quarter for the final quarter of 2023 by the Shared Services Division. April was selected because she helps each team member set goals and then encourages them and offers support, so they have the confidence to reach them. She keeps her team current on training, informed about relevant changes and focused on important goals. April not only encourages her staff to search for ways to improve processes, but she also sets an example by continuously searching for process improvements herself. When someone achieves a goal or goes above and beyond what is required, April is quick to offer praise.
Associate of the Quarter—October
Shared Services is recognizing Christine Cooper, appeals specialist in Jurisdiction J Part B Appeals, as the October Associate of the Quarter because of her forethought and outstanding performance on a complicated overpayment Recovery Audit Contractor case. After researching the 200-page case, Christine took the extra time to clearly identify the pages that would need to be reviewed by a nurse at the next stage. Because of Christine’s organization and attention to detail, the nurse was able to complete her review and respond efficiently and the customer received the appeal decision more quickly. In appreciation, the assigned nurse sent an email to the appeals management team to recognize Christine for her excellent teamwork.
Associate of the Quarter—December
Senior administrative associate Kathleen Tiru was named Shared Services’ December Associate of the Quarter because of her commitment to process improvement and a willingness to take on additional responsibilities. Recently, Kate teamed up with another administrative associate to improve subcontractor onboarding procedures. After consulting with all stakeholders and considering everyone’s needs, they developed a cohesive, efficient process.
In addition to her assigned responsibilities, Kate serves as the Palmetto GBA safety officer. In this role, she attends weekly new-hire training meetings to explain safety policies and procedures. She also leads the Palmetto GBA administrative support team, holding monthly meetings so members can share updates and ideas. Kate encourages collaboration and takes the initiative to help make the company better for everyone.
Team of the Quarter
Part A Appeals Lead Team
Shared Services is recognizing the Part A Appeals Lead Team, Reni Gonzalez and Kristin Naylor, as the Team of the Quarter for their outstanding performance during unscheduled software downtime. Reni and Kristin manually backed up system functions so workflow could continue on schedule. The team ran daily test cases, assessed the results and gave progress reports to the team and management in addition to their regular duties. They also sent two daily reports to the Finance Department to ensure any overpayment-related appeals were captured accurately.
Because Reni and Kristin are so knowledgeable about Medicare appeals processes and systems, they could provide timely feedback, double-check cases and monitor workload. The two are an effective team because they communicate with each other, coordinate their efforts, plan ahead so one of them is always available and are willing to support one another to ensure the company is successful.
Process Improvement of the Quarter
Large Batch Activation
Part B Appeals requests submitted through the Palmetto GBA eServices portal are assigned claims control numbers and batched in sets of 50. On high-volume days, this limit could slow the appeals workflow. To address the problem, the Part B Appeals team submitted a request to create a new batch range of 100 for eServices.
Shared Services named this change the Process Improvement of the Quarter for the last quarter of 2023 because the larger batch range eliminated the delays caused by the batch size limit. Over a three-month period, time studies show the department reduced processing time by more than 146 hours. As a bonus, the larger batch size, which is only used by eServices, makes it easy to identify the batch origin.
Team members: Jennifer Foit, Ryan McCall, Tracy Holstein
