Seth Hall Email & Phone Number

Louisville, KY, US

Irving, Texas, United States

• Led a global team with 3 direct and 30 indirect reports, managing a $3M budget and overseeing US-based clients with a focus on global partnerships.
• Successfully grew recoveries from $1.5B to $2.1B—an unprecedented achievement—by developing relationships with 1,000 carriers for eligibility interfaces and claim adjudication for state and federal programs.
• Increased recoveries by 20% year-over-year for four consecutive years through strategic reorganization and team motivation.
• Achieved 100% conversion of carriers to EDI, doubling the number of carriers implementing EDI solutions.
• Designed and implemented an Employer Group recovery strategy, boosting recovery opportunities by 30%.
• Developed and executed a Medicare Part D recovery strategy, enhancing overall business efficiency.

La Grange, Kentucky, United States

• Directed a team of 6 direct reports and 72 total staff, managing a $6M budget with full P&L responsibility to drive operational efficiency in commercial and government Pharmacy retrospective programs for major.
• Spearheaded end-to-end operations, technology, and processes, optimizing overpayment identification and recovery for COB, Retro Terminations, Clinical, Compliance audits, and Reversal/Payer-to-Payer recoveries.
• Successfully led the implementation of two Pharmacy Benefit Managers (PBM) and several large Healthcare payer programs, streamlining operations and enhancing payment integrity.
• Formulated and executed 800 Payer recovery paths for Pharmacy claims, increasing company revenue from $24M to $100M in 5 years with only a 36% staff growth.
• Achieved a 222% increase in recoveries over 6 years by recruiting, training, and building a high-performing team.
• Built performance scorecards, driving 20%+ annual revenue improvement through targeted education and best practice initiatives.

Louisville, Kentucky Area

• Led global team of 100 employees across the US and India, managing a $15M budget with full P&L responsibility, and spearheading IT operations, including HIM, networks, cloud solutions, telecommunications, helpdesk, and.
• Instrumental in transitioning IBM mainframe servers to outsourced solutions, driving operational efficiency and cost savings.
• Guided the organization through rapid growth, mergers, and acquisitions, collaborating with the CEO and COO to strategize on all technology and facility-related decisions.
• Achieved 30% network savings by migrating infrastructure to Cloud and VOIP technologies, improving efficiency and reducing costs.
• Increased system uptime to 99.99% by introducing Six Sigma-based standards, architectural governance, and CRM best practices.
• Implemented integrated scanning process for 24M+ Medicaid applications, streamlining operations and enhancing data accuracy.

Louisville, Kentucky, United States

• Led strategic planning and innovation with 2 direct reports, developing competitive analysis and product offerings for payer and provider markets with a global presence, including operations in India.
• Created and launched the EMPOWER brand, a cloud-based contact center technology serving 300 hospitals, which streamlined call center operations and enhanced service delivery.
• Collaborated with the CEO and state stakeholders to design and implement a Medicaid plan for the State of KY.
• Consulted as Chief Adviser to the CEO on global healthcare strategy, brainstorming innovative solutions aligned with the latest healthcare techniques and reforms.
• Achieved 30% annual savings through the development and evolution of a clearing house strategy, improving operational efficiency and reducing costs across healthcare operations.

Louisville, Kentucky, United States

• Managed a $6M budget while leading a global HIM team of 30, overseeing IBM mainframe operations and establishing a global Helpdesk team to support provider, payer, and banking sectors.
• Drove consolidation of 4 data centers into 2, resulting in $1M in annual savings and significantly elevating operational efficiency.
• Created Medicaid eligibility files for hospitals, implementing matching service to streamline processes and improve data accuracy.
• Established a Center of Excellence in Mumbai, India, to handle HIM activities and CRM programming, and implemented an outsourcing strategy that saved millions in human resource costs while maintaining 99.999% uptime.

Indianapolis, Indiana, United States

• Expanded call center operations from 13 to 2,000 employees, successfully managing a contract to handle 100M+ member calls for the federal government's 1-800 Medicare line, while overseeing a $100M P&L.
• Developed and presented an emergency “State of the Union” call handling plan to White House within hours, ensuring call centers remained operational during critical times and supporting Medicare calls.
• Achieved 6 consecutive superior ratings from CMS, leading to an 8% increase in bonus payments, while exploring new revenue-generating initiatives and consistently driving high performance.
• Directed the creation of 4 contact centers, recruiting and training 1,000 employees in 90 days, and spearheaded installation of Siebel CRM for Medicare, improving client interactions and operational efficiency.

Waterloo, Iowa Area

Team Leader over outsourced call center for 1-800 Medicare. Responsibilities included workflow and call flow administration, Leadership, Project management, and marketing responsibilities. Handled over 100 clients beside 1-800 Medicare for outsourced contact center responsibilities.

Louisville, Kentucky Area

Lead the QA and Training teams for Humana claim center, and lead 5 state claims and customer service operations.

Louisville, Kentucky Area

My career started at Prudential in the Leadership Development Program and quickly was promoted to manager after rotation through out a group health claims and customer service company. Was Manager of Claims and Customer Service, Manager of Cobra Administration, Manager of system conversion unit where we converted over 1,000 clients in 1 year to new.

Bachelor Of Business Administration - Bba, Business Administration And Management, General, 3.6

Activities and Societies: President of Phi Kappa Tau, Half Time activities Director for Homecoming, Parliamentarian for Student.

Law

Activities and Societies: National Committeeman for National Party

2 Years, Law