Tammy Anderson

“I love claims,” Tammy Anderson says. “I have a passion for claims.”

That’s exactly the type of person we want managing claims. Tammy, a Certified Professional Coder, has seen the Dignity Health Management Services Organization (MSO) through an extended period of growth.

In fact, the number of members supported by the MSO has more than doubled, as Tammy’s team of 45 people has taken over processing claims from an outside vendor and had to work restore accuracy and integrity to the process.

One measure of efficiency in a claims operation is auto-adjudication — meaning that a claim can go through the system automatically without a person touching it. When processes support auto-adjudication, our staff can be knowledge workers rather than handling simple data entry. As a result of Tammy’s leadership, the MSO’s auto-adjudication rate went from the low 20th percentile to between 60% and 65% respectively — and they did it in an unheard-of six-month span.

In addition, the MSO has undergone two independent audits, which have shown a 95% accuracy rate, indicating the MSO is paying the right claims and in the right amounts.

While Tammy may be a 14-year veteran of the organization, she’s quick to share the credit for her success.

“I have an awesome team around me. I have wonderful support people who rally together to help accomplish any goal we set for ourselves,” she says. “And the claims shop is also dependent on outside departments, like the configuration, eligibility, and authorization teams. Those folks are crucial to our success.”

Thanks for all you do to bring everyone together, Tammy!