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Medical Claims

Location:
Clute, TX
Posted:
April 24, 2021

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Resume:

*** *****

Lake Jackson, Texas *****

Phone No.: 979-***-****

E-mail: adlxsj@r.postjobfree.com

Ken Kelley

Summary of Accomplishment

Consistently maintained quarterly bonuses at Crawford and Company working commercial liability and property claims from 2009 through 2014.

Handled commercial property claims due to damage from Hurricanes-Francis, Ike, Jeanne, Katrina and Wilma from 2003 through 2008 in Florida, Mississippi and Texas. Consistently recognized as the leading adjuster, based on annual file reviews within my department, exceeding company requirements, while working for Cunningham Lindsey from 1996 through 2002. Received departmental recognition for consistent recovery of subrogation while working for Metropolitan Transit Authority in 1995.

Work Experience

Independent Property Adjuster, Houston, TX: October 2016-Present: Job duties including handling residential and commercial claims in the surrounding Houston area for various independent adjusting firms.

Eagle Adjusting-Claims Adjuster, Houston, TX: 2015-September 2016 Job duties include handling residential and commercial claims in the surrounding Houston area. Crawford & Company-Multi-Lines Adjuster, Houston, TX: 2009-2014 Job duties include handling commercial liability and property claims daily which includes taking recorded statements, taking photographs, preparing reports, completing diagrams, attending mediations and trials along with writing estimates for property claims. Deal directly with multiple attorneys and their firms setting up meetings with their clients to take recorded statements, negotiate settlements and various other legal matters. Excellent communication skills in dealing with complicated legal matters from reviewing contracts to negotiating complicated bodily injury claims.

Pilot Catastrophe-Adjuster, Mobile, AL: 2005-2009 Job duties included handling commercial property claims in a wide variety of industries which included industrial, medical and construction. Ward North America-Claims Adjuster, Houston, TX: 2003-2005 Job duties included handling workers compensation claims which required the taking recorded statements, paying workers compensation benefits along with analyzing and medical bills. Handled workers’ compensation claims for the City of Houston. Dealing directly with the represented claims and their staff on disputed and complicated claims.

Cunningham Lindsey-Claims Adjuster, Houston, TX: 1996-2002 Job duties included handling workers compensation claims which required the taking recorded statements, paying workers compensation benefits along with analyzing medical bills. Handled workers’ compensation claims for Sisters of Charity, which are a chain of hospitals throughout Texas. Direct dealings with defense and plaintiff attorneys on disputed claims in various jurisdictions all the way to the Texas Supreme Court. Some of my Appeals Panel Decisions for disputed claims are considered benchmarks for certain types of disputed claims.

Metropolitan Transit Authority-Claims Adjuster, Houston, TX: 1995-1996 Job duties included handling workers compensation claims which required the taking recorded statements, paying workers compensation benefits along with analyzing medical bills. Handled workers’ compensation claims for Metro. Negotiated subrogation matters directly with the plaintiff attorney’s along discussing progress of the claims with union representatives. Excellent communication skills required in completing weekly reports along with requiring authority for settlement from upper management. Summit Risk-Claims Adjuster-Houston, TX: 1993-1994 Job duties included handling workers compensation claims which required the taking recorded statements, paying workers compensation benefits along with analyzing medical bills. Handled workers’ compensation claims for the City of Houston. Many of the claims handled were complicated and litigated files requiring daily discussions with plaintiff attorneys to settle claims and negotiate legal matters. Employer's Insurance of Texas-Multi-Lines Claims, Lake Jackson, TX.: 1988-1993 Job duties included handling commercial and residential claims which included liability, automobile, workers' compensation, property and longshoreman for all types of industries from industrial to construction. This included taking recorded statements, photographing accident scenes and property losses along with completing diagrams and reports. Dealt with various plaintiff and defense attorney negotiating settlements along with preparing for trial.

Accreditations and Training

Licensed Multi-line Claims Adjuster (08) in State of Texas from 1988-present Education

University of Texas-Austin; Graduate with BBA in Finance; 1984-1986



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