Kelly Cribbs
Tulsa
Summary
Motivated All Lines Adjuster specializing in workers compensation. Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and dependable.
Overview
27
27
years of professional experience
Work History
Workers’ Compensation Adjuster- Oklahoma
CompSource Mutual
01.2014 - Current
- Responsible for customer service relations to injured claimants, medical providers, attorneys, agents and employers
- Handle a caseload of 130 lost time claims with 80% litigation with a jurisdiction of Oklahoma
- Supply authorization for medical care, services and expenses for injured claimants
- Issue compensation checks and negotiate settlement of claims
- Respond to legal correspondence, including attending depositions, mediations, hearings and trials
- Provide written and verbal claim summaries to agents, employers, and management that include claim history, negotiation strategies and plan of action for resolution
- Review bills of services incurred and issue payment as necessary
- Delegate specific tasks and duties to an assistant and a nurse case manager
Human Resources/ Benefits Manager/ Workers’ Compensation Coordinator
The Oakley Companies
01.2010 - 01.2014
- Responsible for conducting interviews, terminations and new hire orientation
- Directly supervised administrative support positions
- Provided guidance and recommendations to managers regarding annual performance reviews and disciplinary actions
- Developed and administered all employee benefits from negotiation to open enrollment
- Processed payroll time and attendance for all administration and management payroll
- Handled all FMLA, STD/ LTD and LOA for employees
- Completed all EEO-1 reporting
- Review for approval all new potential employees
- Attend local job fairs for potential candidates
- Plan and coordinate special events such as the annual health fair, driver appreciation week and company luncheons
- Maintained all duties of the Workers’ Compensation Coordinator
Workers’ Compensation Coordinator
The Oakley Companies
01.2010 - 01.2014
- Responsible for handling all workers’ compensation claims, reporting claims to the insurance company and OSHA
- Filing first report of injury
- Authorizing initial medical care
- Coordinated travel arrangements for purposes of medical care and treatment of injured worker to home state
- Complete start up of claims database for tracking, diary and note entry for employer use
- Developed a return to work program for injured workers
- Attend mediations, depositions and attorney conferences
- Negotiated settlement with injured workers and counsel
- Negotiated medical bills for payment
- Completed background investigations of injured workers
Field Adjuster
SIU Central
01.2009 - 01.2010
- Responsible for contacting injured workers, claimants and other parties related to insurance claims
- Obtaining recorded statements of details of claims, photographing accident sites, claimants and parties related thereto
- Obtaining paperwork and file materials
- Preparing reports for adjusters and insurance representatives
- Prepare final bill for invoicing
Workers' Compensation Adjuster-Florida
Summit Consulting, Inc.
01.2006 - 01.2007
- Responsible for customer service relations to injured claimants, medical providers, attorneys, agents and employers
- Handled a caseoad of 110 lost time claims with 95% litigation with a jurisdiction of Florida
- Investigation of claims, identification of claims for OSHA reference
- Supply authorization for medical care, services and expenses for injured claimants
- Issued compensation checks and negotiated settlement of claims
- Responded to legal correspondence, including attending depositions, mediations and hearings when required
- Provided written and verbal claim summaries to agents, employers, management and third party liaison's that included claim history, negotiation strategies and plan of action for resolution
- Reviewed bills of services incurred and issued payment as necessary
- Worked with employers to develop procedures that would reduce workers' compensation loss and liability loss
- Assigned defense counsel to claims as needed
- Delegated specific tasks and duties to an assistant and a nurse case manager
Case Manager
Burnetti, P.A.
01.2005 - 01.2006
- Responsible for setting up new workers’ compensation, personal injury, wrongful death and slip and fall cases
- Initiated and maintained contact with the clients, insurance carriers and medical providers
- Requested and reviewed insurance policies, medical records and property damage estimates
- Corresponded and negotiated settlements with insurance adjusters
- Negotiated client medical bills that have outstanding balances
- Met with clients via in person or telephonic every 30 days to provide case status updates
- Maintained a working diary of clients
- Prepared demand packages for submission to the insurance carriers and prepared closing packages at the end of the case
- Assisted the lead attorney in all pre-suit litigation cases for settlement purposes
- Maintained a case load of 150 client files
- Delegated minimal responsibility tasks to pre-suit assistants
Workers' Compensation Adjuster- Florida
Summit Consulting, Inc.
01.2002 - 01.2004
- Responsible for customer service relations to injured claimants, medical providers, attorneys, agents and employers
- Handled a caseload of 120-125 lost time claims with 90% litigation, including handling 4 special accounts with a jurisdiction of Florida
- Investigation of claims
- Identification of claims for OSHA reference
- Supply authorization for medical care, services and expenses for injured claimants
- Issued compensation checks and negotiated settlement of claims
- Responded to legal correspondence, including attending depositions, mediations and hearings when required
- Provided written, verbal and visual claim staffing's to agents, employers, management and third party liaison's that included claim history, negotiation strategies and plan of action for closure
- Reviewed bills of services incurred and issued payment as necessary
- Worked with employers to develop procedures that would reduce workers' compensation loss and liability loss
- Assigned defense counsel to claims as needed
- Delegated specific tasks and duties to an assistant and a nurse case manager
Worker's Compensation Adjuster- Florida
Publix Super Markets, Inc.
01.1998 - 01.2002
- Responsible for customer service relations to injured associates, attorneys and medical providers
- Handled a file count of 175-200 lost time claims with 75% litigation with a jurisdiction of Florida
- Supplied authorization for medical care, expenses and services to injured employees including negotiating fees and process for the same
- Reviewed bills of services rendered and issued payment as necessary
- Issued compensation checks and negotiated fees and prices for the same
- Issued indemnity checks and negotiated settlement of claims
- Responded to legal correspondence including attending depositions and mediations
- Assigned defense counsel to claims as needed
Education
Multi-Lines Adjuster -
Tulsa, OK01.2015
South Florida Community College -
South Florida Community College
Wauchula, FL01.2012
Board Certification in Workers' Compensation - Florida
Lakeland, FL01.2006
General Lines Adjuster's License -
Lakeland, FL01.2002
Workers' Compensation Adjuster's License - Florida
Lakeland, FL01.1999
diploma -
Bartow High School
Bartow, FL01.1995
Skills
- Claims investigation
- Legal compliance
- Policy interpretation
- Claims management
- Multitasking
- Effective communication
- Decision-making
- Analytical thinking
- Conflict resolution
- Risk assessment
- Coverage determination
- Complex Problem-solving
- MS office
- Settlement negotiations
- Settlement negotiation
- Human relations
- Negotiation and mediation
- Professional demeanor
Timeline
Workers’ Compensation Adjuster- Oklahoma
CompSource Mutual
01.2014 - Current
Human Resources/ Benefits Manager/ Workers’ Compensation Coordinator
The Oakley Companies
01.2010 - 01.2014
Workers’ Compensation Coordinator
The Oakley Companies
01.2010 - 01.2014
Field Adjuster
SIU Central
01.2009 - 01.2010
Workers' Compensation Adjuster-Florida
Summit Consulting, Inc.
01.2006 - 01.2007
Case Manager
Burnetti, P.A.
01.2005 - 01.2006
Workers' Compensation Adjuster- Florida
Summit Consulting, Inc.
01.2002 - 01.2004
Worker's Compensation Adjuster- Florida
Publix Super Markets, Inc.
01.1998 - 01.2002
Multi-Lines Adjuster -
South Florida Community College -
South Florida Community College
Board Certification in Workers' Compensation - Florida
General Lines Adjuster's License -
Workers' Compensation Adjuster's License - Florida
diploma -
Bartow High School
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