Karen Foster

Senior Claims Resolution Specialists

Encova Insurance (formerly Motorists Insurance)

Columbus, Ohio

01.1998 - Current

Ensured compliance with applicable laws, regulations, policies and procedures when processing claims.
Adhered to established workflow processes and timelines in order to meet performance goals.
Initiated contact with customers by phone or mail concerning claim status updates.
Processed payments promptly upon approval of a valid claim.
Analyzed claim documents, such as medical records, bills and invoices, to ensure accuracy of information.
Tracked progress of open claims through various stages until completion.
Reviewed, evaluated and processed incoming claims to determine eligibility for coverage based on policy provisions.
Researched complex insurance issues to resolve discrepancies in claims data.
Provided guidance and advice regarding policies and procedures for filing a claim.
Prepared detailed reports summarizing all activities pertaining to each claim.
Collaborated with other departments to obtain additional information needed for claim resolution.
Maintained accurate records of all communications with customers regarding their claims.
Investigated and resolved customer inquiries related to the status of their claims.
Negotiated settlements between claimants and insurance companies in order to reach an agreement.
Organized estimation, repair, and rental services to support claims processing and policyholder needs.
Detailed coverage, liability and reasons for denial of claims to policyholders, attorneys, and third-party providers.
Investigated, evaluated, negotiated and settled total loss auto claims in collaboration with customers, repair shops and service providers.
Performed investigations, evaluated, negotiated and settled total loss auto claims in collaboration with customers, auto body shops and service providers.
Discussed current cases and issues in claim committee meetings.
Researched claims in order to evaluate correct coverage and liability.