Kellie Earls
Mount Juliet
Summary
Results-driven workers' compensation claims adjuster with expertise in claim investigation and settlement negotiation. Demonstrated ability to ensure compliance with regulations while effectively managing complex cases. Strong analytical and communication skills contribute to successful outcomes and client satisfaction.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Workers' Compensation Claims Adjuster
Public Risk Services
Brentwood
07.2012 - 04.2026
- Completed TN Adjuster Certification Program.
- Dedicated adjuster to several Tennessee Municipalities
- Reviewed workers' compensation claims for accuracy and compliance with regulations.
- Investigated claim details through interviews and documentation analysis.
- Coordinated with medical providers to gather necessary treatment records.
- Communicated claim decisions clearly to claimants and employers.
- Evaluated evidence to determine claim validity and potential fraud risks.
- Maintained up-to-date knowledge of workers' compensation laws and policies.
- Documented all claims activities in the claims management system accurately.
- Maintained current knowledge of claim reserve levels and prepared reports on funds available for distribution to claimants to prevent overdraft.
- Negotiated settlements between claimants and employers or insurers when appropriate.
- Provided customer service by responding promptly to inquiries from claimants, employers, attorneys and other stakeholders.
- Developed strategies to resolve complex cases within established timeframes.
- Reviewed medical records, interviewed employers and claimants, analyzed wage loss calculations, and reviewed evidence for accuracy.
- Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
Workers' Compensation Claims Examiner
Broadspire
Nashville
06.2010 - 06.2012
- Reviewed and processed claims for accuracy and compliance with company policies.
- Paid and processed claims within designated authority level.
- Developed a detailed understanding of the company's policies and procedures related to claim processing and payment determination.
- Investigated discrepancies in claims and resolved issues with customers via telephone or written correspondence.
- Participated in quality assurance activities such as peer reviews and audits.
- Completed required investigations on referred files within established timeframes.
- Entered claim transactions, payments, reserves and other documentation.
- Reviewed medical records and documents to determine coverage eligibility of claims for insurance benefits.
- Handled and processed variety of claims.
- Processed claims payments and denials in accordance with company procedures.
- Negotiated settlement terms with claimants within authorized limits.
- Coordinated with legal counsel on complex claims requiring litigation.
Workers' Compensation Supervisor
Harleysville Insurance Company
Nashville
04.2008 - 09.2009
- Supervised daily operations and ensured compliance with company policies.
- Trained and mentored team members to enhance performance and skills.
- Coordinated workflow processes to optimize efficiency in service delivery.
- Managed customer inquiries and resolved issues promptly and effectively.
- Conducted regular performance evaluations and provided constructive feedback.
- Provided guidance and direction to subordinates regarding job duties and responsibilities.
- Directed and supervised a team of four employees in daily operations.
- Maintained accurate records of employee performance, attendance, leave requests, and disciplinary actions.
- Recruited, hired, trained, mentored, coached, evaluated, and terminated staff as necessary.
Workers' Compensation Unit Leader / Sr WC Analyst
Indiana Insurance Company
Nashville
10.2003 - 04.2008
- Led team meetings to discuss project updates and workload distribution.
- Coordinated with departments to improve workflow and enhance collaboration.
- Developed training materials for new team members to ensure consistency.
- Monitored team performance and provided feedback for process improvements.
- Managed project timelines to meet company objectives and deadlines.
- Conducted regular meetings with staff members to review progress and discuss challenges.
- Coordinated closely with upper management to ensure that goals were met efficiently.
- Recruited qualified candidates for open positions within the unit.
- Established strong relationships with vendors and suppliers in order to secure favorable terms.
- Identified opportunities for improvement in existing systems or processes, then implemented changes accordingly.
- Monitored team performance to identify areas for improvement.
- Assigned tasks according to individual abilities and strengths of employees.
Education
Associate of Arts -
Cumberland University
Lebanon, TN05-1980
Skills
- Claim investigation and resolution
- Settlement negotiation
- Insurance compliance and regulatory knowledge
- Case management
- Medical record analysis
- Customer communication
- Workers' compensation laws
- Claims management
- Computer proficiency
- Analytical thinking
- Communication skills
- Teamwork and collaboration
Certification
Adjuster Certification Program
References
References available upon request.
Timeline
Workers' Compensation Claims Adjuster
Public Risk Services
07.2012 - 04.2026
Workers' Compensation Claims Examiner
Broadspire
06.2010 - 06.2012
Workers' Compensation Supervisor
Harleysville Insurance Company
04.2008 - 09.2009
Workers' Compensation Unit Leader / Sr WC Analyst
Indiana Insurance Company
10.2003 - 04.2008
Associate of Arts -
Cumberland University