Coach of the Quarter – Cathleen Kirchenberg

Cathleen Kirchenberg, an Appeals Analyst, has with extensive experience in handling Medicare claims. She has played a significant role in training and guiding nurses on both the Jurisdiction M (JM) and Jurisdiction J (JJ) Appeals Teams, as well as assisting and training nurses in Prepay and Home Health contracts. Her diverse skillset and knowledge have been instrumental in helping Palmetto GBA teams achieve their goals. Cathleen is not only a registered nurse but also a certified coder, providing invaluable expertise on coding, medical, and clinical issues. She conducts monthly nurse training sessions and serves as a coach, quality assurance (QA) reviewer, and nurse lead for the appeals department. Cathleen is always willing to share her knowledge and resources, taking the time to explain the correct decisions and steps involved. Her supportive and uplifting attitude has helped her team grow and thrive under her guidance. Congratulations Cathleen for being announced as our Coach of the Quarter. 

Process Improvement of the Quarter – Pending Age report tracking for objectives

Before the implementation of this new process, the claims support staff kept a record of all clean claims that were processed within 45 days and calculated the percentage by dividing them by the total pending claims.

After implementation, a new tracking system was developed to document exclusions of clean claims processed from locations or Common Working File (CWF) error codes that the claims team has no control over. This new tracking system provides an updated percentage of claims processed within 45 days, which is used for reporting the support and management team's yearly objectives. Congratulations to Part B Claims Processing for improving accuracy and efficiency with this new process and being named our Process Improvement of the Quarter.

Team Members: Lovealee Blevins and Lori Holsinger

Associate of the Month (January) - Kimberly Staten

As a Senior Operations Analyst, Kimberly Staten is committed to ensuring the quality of her team's work. Recently, there was a surge in appeal reports due to a team member retiring. Kimberly personally trained three new members to assist with these reports, ensuring that projects are completed on time. She consistently meets her reporting and analysis standards and is frequently sought after for her expertise. Kimberly's dedication to maintaining high-quality standards and ensuring efficient and accurate work is truly admirable. We are proud to announce Kimberly Staten as our Associate of the Month.

Associate of the Month (February) - Toccora Wilson

Our Associate of the Month is Toccora Wilson, an appeals analyst who is a great team player. Toccora is always willing to pitch in and help with projects, and most recently she provided backup support to the Jurisdiction J (JJ) inbox while the team lead was away. She is also very supportive and knowledgeable, taking the time to research and provide accurate answers to questions. Toccora consistently meets and exceeds quality standards, especially in her work with Skilled Nursing Facilities (SNF) cases, where she has an average score of 99% for the last 3 months. We are proud to recognize Toccora for her outstanding performance and leadership.