Coach of the Quarter – Melissa Murren

Medical Review supervisor, Melissa Murren, is an encouraging, determined, and constructive leader who devotes extra time to assure her staff are supported in their roles. Melissa’s encouraging emails, phone calls, team meetings, and one-on-one check-ins are well-received by the team. Her team says, "We've learned so much from Melissa. She is a great listener, motivator, communicator, and most of all, friend."

Process Improvement of the Quarter – Part B Appeals Nurse Quality Assurance Verification 

Part B appeals team completes quality audits for appeal decisions. The audits include a review of decisions made by the appeals clinical staff. During the quality auditing process, the appeals team occasionally finds a need to either make a correction to a prior decision or add some clarifying information to the prior letter that was completed. The part B appeals team added a step to the process to allow for quicker corrections.

The new step includes notifying the appeals leads and management of the quality audit results at the time the audit is added to the workflow management system and sent to the appeals associate. The appeals lead or managers issue a new Correspondence Control Number (CCN), right away, and the case is assigned to the appeals specialist for updating the adjustment and providing a corrected letter.

The new step enables the appeals team to track updates ensuring all updates are made more efficiently and accurately. It has also allowed the leads to identify additional training needs and is projected to result in reducing costs.

Associates of the Month

April – Tina Patterson

Tina Patterson, a Medicare Secondary Payer (MSP) processor, has been a part of the JJ/JM MSP team for seventeen years and has been a member of the Palmetto GBA family for over thirty-four years. Due to her years of experience, Tina has a vast knowledge of her role. She catches on quickly when changes occur and doesn't hesitate to share her wisdom with fellow team members. She exceeds departmental standards daily and is quick to pick up any extra work. Tina is very conscientious about her work and her depth of knowledge makes her a great resource for questions. Tina exemplifies an exceptional employee and we're excited to see what she does in the future.

May – Georgia Ford

Georgia Ford is an Appeals Analyst who works efficiently to meet all deadlines, external and internal metrics. She assists with evidentiary hearing cases, warm transfer calls, and volunteers to assist with any additional work that may be needed. Georgia's commitment to success is demonstrated not only in the amount of work she completes, but in the quality as well. Her team says it best "It is employees like Georgia who have made Palmetto GBA the success it is. Consistent, honest, friendly, supportive, knowledgeable are a few words that we use to describe Georgia."