Karen Klein-Sodemann
Waukesha,WI
Summary
Claims professional with extensive experience in managing and resolving insurance claims. Recognized for delivering high-quality service and achieving positive resolutions. Known for exceptional teamwork, adaptability, and proficiency in claims processing and customer service.
Overview
27
27
years of professional experience
Work History
Claim Specialist
Cities and Villages Mutual Insurance Company
05.2024 - Current
- Coordinated with insurance adjusters for claim evaluations.
- Communicated with clients to gather necessary information.
- Investigated discrepancies in claims submissions.
- Reviewed claims for accuracy and completeness.
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
- Participated in ongoing professional development courses to stay updated on best practices within the industry.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Enhanced customer satisfaction with timely and empathetic communication throughout claim process.
Claim Specialist
Corvel Corporation
03.2017 - 05.2024
- Coordinated with insurance adjusters for claim evaluations.
- Communicated with clients to gather necessary information.
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
- Participated in ongoing professional development courses to stay updated on best practices within the industry.
- Negotiated favorable settlements with policyholders and third-party representatives, minimizing financial losses for the company.
- Fostered team-oriented environment that emphasized continuous improvement in claim handling procedures.
- Enhanced customer satisfaction with timely and empathetic communication throughout claim process.
Senior Resolution Specialist
Gallagher Bassett
03.2012 - 03.2017
- Leveraged advanced problem-solving skills to address difficult or escalated cases, ensuring customer satisfaction.
- Maintained detailed records of all resolutions, ensuring accuracy and compliance with regulatory requirements.
- Mentored junior staff members on various aspects of conflict resolution, helping them develop essential professional skills.
- Improved customer satisfaction by efficiently resolving complex issues and providing timely solutions.
- Served as a subject matter expert on state specific statutes to promote best outcomes on claims
- Supported departmental goals by consistently meeting or exceeding performance metrics related to resolutions handled and issue closure rates.
Senior Workers Compensation Claim Consultant
The Hartford
06.1998 - 02.2017
- Optimized customer experience by delivering superior services and effectively troubleshooting issues.
- Devised and implemented processes and procedures to streamline operations.
- Helped meet changing demands by recommending improvements to business systems or procedures.
- Reviewed claims for accuracy and completeness.
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
- Participated in ongoing professional development courses to stay updated on best practices within the industry.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Evaluated medical records as part of injury claim assessments, ensuring an accurate understanding of treatment costs and recovery timelines.
- Mentored junior team members by providing guidance on navigating complex claim scenarios efficiently.
- Enhanced accuracy of claim evaluations by developing and conducting comprehensive training sessions for new staff.
- Subject Matter expert on multiple jurisdiction and coverage certified
Education
Bachelor of Science - Speech Communications And Business Law
University of Wisconsin, Whitewater
Whitewater, WI05-1993
Skills
- Policy interpretation
- Regulatory Compliance
- Financial Analysis Skills
- Claims Analysis
- Analytical Problem Solving
- Claims Evaluation
- Client Support
- Effective Workflow Management
- Collaborative Teamwork
- Claims Evaluation
- Microsoft office
- Analytical Problem-Solving
Current Active MN adjusters license, Experienced in IL, MN, WI, NE, KS, MO jurisdictions
Handled Work Comp claims in several states including Manufacturing, Trucking, Municipal and Corporate Claims.
Timeline
Claim Specialist
Cities and Villages Mutual Insurance Company
05.2024 - Current
Claim Specialist
Corvel Corporation
03.2017 - 05.2024
Senior Resolution Specialist
Gallagher Bassett
03.2012 - 03.2017
Senior Workers Compensation Claim Consultant
The Hartford
06.1998 - 02.2017
Bachelor of Science - Speech Communications And Business Law
University of Wisconsin, Whitewater
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