Happenings
The Shared Services Division Announces Q4 2024 Awards
Associate of the Month — October
ReeShema Pee
The Shared Services Division has named ReeShema Pee, a hearings specialist in Appeals, October’s Associate of the Month for the 2024 fourth quarter because of her exceptional leadership, strong work ethic and dedication to improving work processes. She is known for her kindness, generosity and ability to meet and exceed deadlines. ReeShema played a key role in implementing two new processes that enhance the efficiency of rescheduled hearings, significantly benefiting the Contractor Medical Directors. Her peers and management frequently commend her for her outstanding work, reliability and ability to handle tasks with grace and accuracy. ReeShema's contributions make her an invaluable asset to her team.
Associate of the Month — December
Dani Hernandez
Known for her courteous and helpful nature, Dani Hernandez, a registered nurse and senior medical reviewer in the Appeals Department, has made significant contributions by addressing hospice-related queries made by the review team. Recently promoted to her current position, she has efficiently managed multiple tasks and provided professional support. Dani's willingness to assist and encourage her team members, along with her ability to handle increased hospice workloads, highlights her exceptional performance in her new role. Her willingness to step up has earned Dani the Associate of the Month award for December.
Coach of the Quarter
Lori Holsinger
Lori Holsinger, a manager in Claims Operations, is often praised for her exceptional dedication and support of her team and has been named Coach of the Quarter. She keeps current on changes to processing by participating in training sessions and steps in to train new associates when needed. Lori is known for being attentive to her team member’s personal and professional needs. She is also appreciated for her respectful and knowledgeable approach, and her commitment to understanding and improving work processes. Lori addresses issues with grace, listens to all perspectives and provides constructive criticism to enhance efficiency. Her positive attitude, continuous support and willingness to exceed expectations make Lori a valued leader and trusted friend to her team.
Process Improvement of the Quarter
Automation of procedure codes with no documentation
Team members: LoveaLee Blevins, Tricia Cordell, Angela Culver, Laurie Donahue, Tathiane Flint, Lori Holsinger, Crissy Jackson, Karen Lee, Juanita Whiteman
The Claims Production and Pricing Department team noticed that claims with two specific procedure codes often needed extra documentation to determine coverage or pricing. Many of these claims were held up for manual review because they lacked adequate documentation, which caused delays. To solve the problem, the team had the system updated to automatically deny claims with these codes if they didn't include the required documentation. This removed the need for manual review. This update significantly reduced the number of claims needing manual intervention, speeding up the process.
Team of the Quarter
Jurisdiction M Appeals Home Health & Hospice
Team members: Candice Allison, Logan Autry, Amber Boatwright, Kristen Buckley, Samantha Cloud, Georgia Ford, Cheri Hagood, Paula Hemphill, Dani Hernandez, Jessica Klein, Wendy Littleton, Danny Scott, Page Shepard, Nicole Teal, Clyde (Ben) Turner, Paula Woodard
The Jurisdiction M Appeals Home Health & Hospice team has been named Team of the Quarter for their outstanding performance, effective communication and commitment to quality. Their seamless collaboration, use of efficient communication tools and dedication to maintaining high standards have been key to their success. The team fosters a supportive environment, participates in team-building activities and consistently meets or exceeds the Center for Medicare & Medicaid Services’ standards. Their culture of knowledge sharing and continuous improvement enhances their performance, making them truly deserving of this recognition.
