Coach of the Quarter – Tricia Cordell

Tricia Cordell is a Claims Manager who is highly dedicated to her work. She is an excellent team player who doesn't hesitate to help with maintenance approvals in the workflow management system (iFlow) to ensure timely and correct implementation of all Technical Direction Letters (TDLs). Tricia is always willing to provide one-on-one guidance to team members who need additional training or have any questions. She goes beyond her management duties to ensure the team is set up for success. We are proud to announce Tricia as our Shared Services Coach of the Quarter for her leadership, hard work, and commitment to quality.

Team of the Quarter – Part A Appeals, Home Health and Hospice

The Part A appeals home health and hospice team is extremely efficient and successful in meeting the standards set by the Centers for Medicare & Medicaid Services (CMS) and Palmetto GBA. The team works in a highly organized manner, with well-defined processes fine-tuned over time. Each member of the team brings years of experience, knowledge, and skills to the table, and their ability to work together seamlessly is what sets them apart. Despite any challenges they face, the team can meet their targets with confidence, thanks to their commitment and dedication to their work. What's even more impressive is their willingness to help others without being asked. Overall, the Part A appeals team is a shining example of what a team should be, and their dedication to quality work is commendable. Congratulations to the team for being recognized as the Team of the Quarter for the Shared Services Division.

Team Members: Candice Allison, Kristen Buckley, Sylvia Clingman, Samantha Cloud, Michael Cofer, Georgia Floyd, Cheri Hagood, Paula Hemphill, Dani Hernandez, Tabatha Huffmaster, Jessica Klein, Wendy Littleton, Danny Scott, Lindsey Sherrill, Julia Nicole Teal, Chandra Thomas, Clyde Turner, and Paula Woodard

Process Improvement of the Quarter – Duplicate Enhancements 

The Part B claims processing team created a process improvement for Part B Claims that involved performing root cause analysis on claims that were suspended due to Multi-Carrier System (MCS) audits as potential duplicates. They found that several changes could be made to automate or eliminate the suspense. As a result, they updated the duplicate audit logic to eliminate unnecessary suspense by allowing the MCS audit logic to auto-adjudicate specific situations. This new process helped reduce duplicate audit suspense volumes by an average of 35%, saving thousands of manual hours, resulting in significant annual savings.

Team Members: Lovealee Blevins, Tricia Cordell, Evelyn Craig, Angela Culver, Kim Foster, Lori Holsinger, Tracy Holstein, and Monica Williams

Associate of the Month (April) – Sandra Hyder

Sandra Hyder is a database report writer/analyst possessing extensive knowledge in her field. She has a remarkable ability to troubleshoot queries or file downloads and resolve any issues that may arise. Sandra is proactive in identifying the root cause of problems and fixing them quickly and efficiently.

Her work consistently exceeds our Pricing Team's quality standards. Additionally, she manages the duties associated with the Part B Drug Crosswalk while ensuring the timely delivery of monthly and quarterly files to the Centers for Medicare & Medicaid Services (CMS). Often, she sends these files before the expected due dates.

CMS occasionally requests pricing for specific drugs via email during these periods. Sandra responds to these requests on the same day, while continuing to stay on top of her work. In cases where further research is required, she follows up until the requested information is provided.

Due to her exceptional work ethic, we are pleased to announce her as our Shared Services Associate of the Month.

Associate of the Month (May) – Tammy Lassiter 

Tammy Lassiter, an Appeals Specialist, is known for her exceptional work ethic. She ensures that all tasks are completed accurately and on time. Tammy is always willing to lend a hand, even if the project is not directly related to her role. Recently, she has taken the lead role for the warm transfer process in appeals and ensured that all customers' needs are met. Tammy is also an excellent resource when updating and revising Inquiry Tracking System (ITS) work instructions. Providers have praised her for her prompt and effective responses when handling ITS tickets and making provider callbacks. Her team members have described her as a "shining light" in the appeals department. Congratulations to Tammy for being named our Shared Services Associate of the Month.