Kelly Halton Email & Phone Number

Buffalo, NY, US

Buffalo, New York, United States

• Negotiate and maintain contracts with out-of-network providers, ensuring favorable terms and cost savings for the organization.
• Identify and analyze inefficient processes, leading to the implementation of streamlined workflows that will increase productivity.
• Demonstrate exceptional attention to detail in managing complex projects, ensuring accuracy and compliance with organizational standards.
• Exhibit clear and concise communication in all interactions, ensuring that complex information was easily understood by stakeholders at all levels.
• Develop and build trust with providers, forming strong and lasting relationships that enhance collaboration and service delivery.
• Develop comprehensive quality assurance frameworks, ensuring consistent adherence to industry standards and best practices.

Getzville, New York, United States

• Created and implemented new department processes, enhancing operational efficiency and effectiveness.
• Served as a subject matter expert, providing guidance and support to team members to ensure successful adoption of new processes.
• Mentored and provided guidance to new hires, fostering a culture of continuous learning and professional growth within the customer service team.
• Managed a team of claims associates, overseeing daily operations and ensuring adherence to company standards and policies.
• Delegated tasks effectively, balancing workloads and ensuring timely completion of claims processing.
• Developed and implemented comprehensive training programs for new and existing customer service representatives, focusing on product knowledge, communication skills, and service excellence.

Getzville, New York, United States

• Investigated and assessed insurance claims promptly and accurately, utilizing phone interviews, documentation review, and data analysis to determine coverage, liability and settlement options.
• Conducted thorough phone interviews with claimants, witnesses, and other relevant parties to gather necessary information.
• Reviewed and analyzed documentation such as medical records, police reports, and policy details to support claim assessments.
• Utilized data analysis to identify patterns and discrepancies, ensuring accurate and fair claim resolutions.
• Collaborated with legal and medical professionals to validate claims and determine appropriate settlement options.
• Negotiated settlements with claimants, attorneys, and third-party vendors to achieve fair and equitable resolutions in accordance with policy terms and company standards.

Master'S Degree, Elementary Education And Teaching

Bachelor'S Degree, Social Sciences