Kelly Kavali
Akron,OH
Summary
Medical Claims Analyst with experience in adjudicating, auditing, and analyzing complex claims in a TPA environment. Skilled in CPT/HCPCS and ICD-10 coding and claims issue resolution. Strong background in supervising, training, documentation, and process improvement with hands-on experience using Javelina and HealthPac platforms.
Overview
35
35
years of professional experience
Work History
Claims Auditor/Claims Supervisor/Trainer
Contigo Health
06.2013 - 12.2025
- Managed multiple concurrent audits, prioritizing tasks to meet deadlines while exceeding productivity and quality standards.
- Supervised a team of 20 + claims examiners. Tasks included assigning daily work loads, assisting with problem claims, training, and high dollar claim review.
- Conducted interviews for potential employees and provided training to new hire auditors and claims examiners.
- Collaborated with cross-functional teams on the Quality Committee to streamline audit processes.
- Tested new systems, policies and procedures.
Claims Auditor/Stop Loss Coordinator
American Benefits Management
06.2007 - 06.2013
- Adjudicated, audited, and provided customer service for multiple accounts.
- High dollar claim review and stop loss submissions.
- Provided monthly training to claims examiners based on audit results.
- Exceeded productivity and quality standards.
Office Manager/Insurance Agent
McClay Agency
06.2003 - 06.2007
- Supplied quotes and signed policies for Life, Health, Property and Casualty policies to clients.
- Managed all aspects of the office including customer service, accounting, and scheduling.
Claims Examiner/Customer Service
American Benefits Management
06.1999 - 06.2003
- Processed medical, dental, and vision claims for multiple clients while providing customer service.
- Participated in annual Health Fair to provide in person Q&A to members.
- Exceeded productivity and quality standards.
Claims Examiner
Benefit Services
09.1994 - 06.1999
- Audited claims for accuracy and alignment with company policy and state/federal law.
- Exceeded productivity and quality standards.
Data Entry
Metlife
10.1990 - 09.1994
- Entered medical, dental, and vision claims into the claims processing system.
- Provided training on system issues and solutions.
- Assisted claims examiners with documentation requirements.
Education
High School Diploma - undefined
Ellet High School
Skills
- Claims Adjudication
- CPT/HCPCS & ICD-10 Coding
- Medical Claims Analysis
- SOP Development
- Process Improvement
- Training & Documentation
- COB & Claim Adjustments
- Javelina
Timeline
Claims Auditor/Claims Supervisor/Trainer
Contigo Health
06.2013 - 12.2025
Claims Auditor/Stop Loss Coordinator
American Benefits Management
06.2007 - 06.2013
Office Manager/Insurance Agent
McClay Agency
06.2003 - 06.2007
Claims Examiner/Customer Service
American Benefits Management
06.1999 - 06.2003
Claims Examiner
Benefit Services
09.1994 - 06.1999
Data Entry
Metlife
10.1990 - 09.1994
High School Diploma - undefined
Ellet High School