Claims professional

KIMBERLY A. KARLSSON

Chicago, IL 614-***-**** ********@*****.***

http://linkedin.com/in/kimberly-karlsson-656a601a

PROFESSIONAL SUMMARY

Senior Insurance Specialist with 20+ years of experience. Proven ability to cultivate high-trust relationships with agents, underwriters, and clients that translate technical claims and policy knowledge into lasting partnerships. Skilled at coordinating complex casework and multi-stakeholder projects with a focus on compliance, customer satisfaction, and sustainable revenue growth. Experienced in claims analysis, data-driven reporting, and program performance optimization across diverse insurance lines

CORE COMPETENCIES

• Xactimate Estimating • Guidewire Claims Management

• Large Loss Documentation • Fraud Prevention & Investigation

• Replacement Cost / Depreciation • Carrier Program Compliance

• Settlement Negotiation • Insurance Law & Testimony

• Business Development & Sales • Team Leadership & Training

• Customer Experience Management • Project & File Management

Licensed Adjuster: FL, TX, WY, NM, OK Technology: Microsoft Office 365, Xactimate, Guidewire

PROFESSIONAL EXPERIENCE

SERVPRO of Elgin, Aurora, DeKalb County Mar 2025 – Nov 2025

Contents Manager

•Built and maintained relationships with insurance agents, adjusters, and property managers, generating new content and mitigation referral opportunities.

•Partnered with sales, marketing, and production teams to ensure rapid response to new losses—managing the full cycle from referral through job walk, estimate, and authorization.

•Represented the company at claim reviews, on-site inspections, and carrier visits, securing repeat business through service excellence and proactive issue resolution.

•Managed all aspects of the contents department including pack outs, inventory tracking, cleaning, and pack backs for residential and commercial restoration projects.

•Prepared detailed and accurate pack-out estimates aligned with carrier requirements and SERVPRO standards, supporting insurance claims and project budgets.

•Developed and implemented process improvements that streamlined workflow, enhanced customer satisfaction, and drove positive word-of-mouth referral growth.

•Trained and mentored team members on contents handling procedures, estimating best practices, and customer communication standards.

Nationwide Mutual Insurance Downers Grove, IL Dec 2005 – Oct 2024

Large Loss Property Contents Specialist (Oct 2010 – Oct 2024)

•Managed high-severity property contents claims end-to-end, from initial assessment through final settlement, consistently meeting or exceeding resolution timelines.

•Built and sustained long-term relationships with agents, insureds, and preferred vendors while managing complex, high-value property contents claims.

•Collaborated with restoration contractors and content vendors to scope losses, review estimates, and resolve documentation and coverage questions.

•Participated in preferred and direct repair vendor programs, gaining deep insight into how carriers evaluate and select restoration partners.

•Conducted comprehensive investigations of complex claims including detailed site inspections, evidence collection, and fraud prevention analysis.

•Specialized in detailed loss documentation—photographic and video evidence, comprehensive inventories, and thorough cataloging of damaged contents.

•Successfully negotiated settlements while ensuring full compliance with local, state, and federal regulations.

•Provided expert testimony in court proceedings, demonstrating thorough knowledge of insurance law and claim documentation.

Senior Casualty Claims Representative (Dec 2005 – Oct 2010)

•Investigated material and physical damage claims, performed liability determinations, and reviewed estimates to authorize appropriate payments on third-party claims.

•Represented the company in arbitration forum hearings involving liability and property damage disputes, securing favorable coverage decisions.

•Determined proper policy coverage and applied best claims practices to conclude assigned cases in accordance with company guidelines and quality standards.

•Managed preferred and direct repair shop claims, maintaining strong vendor relationships and service quality.

•Maintained current knowledge across multiple insurance lines, court decisions, policy changes, and industry guidelines through ongoing training and professional development.

Nationwide Mutual Insurance Columbus, OH Dec 1999 – Sep 2005

Payroll / Sick Leave / Disability Service Specialist (Mar 2003 – Sep 2005)

•Administered employee payroll, sick leave, and disability benefit programs, ensuring accuracy and compliance with company policies.

•Processed and tracked disability cases, coordinating with HR and management to ensure timely return-to-work outcomes.

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•Researches and resolves unusual, highly technical or complicated inquiries/problems from internal and external customers regarding assigned products

•Responds to inquiries and problems escalated from other Service Representatives.

•Provides quality customer service through a demonstrated understanding of customer needs and timely response to inquiry

•Interprets contract and/or product provisions, internal procedures and controls, and state and federal regulations that apply to assigned products

•Maintains in-depth knowledge of assigned products and processing systems

•Investigates and analyzes service problems and trends uncovered through inquiries and assists in developing corrective actions. Monitors service activity and maintains detailed documentation regarding inquiries

•May respond to government agency, attorney, or Internal Audit inquires regarding assigned products

•Works extensively in the PeopleSoft/HRIS, TOPS (Time Off Planning System) and Case Management systems to perform daily responsibilities

•Works with the department trainer to ensure that the Scripted Knowledge Base (SKB) is up to date with information regarding Payroll, Sick Leave and Disability information that we process

•Handles escalated payroll/sick leave/disability case issues

•Maintains files for various claims offsets. Works closely with Workers Compensation and other state regulated claims

•Consults with the Systems Department with system and web-related issues/problems

Benefits Specialist (Dec 1999 – Mar 2003)

•Served as a resource for associates on benefits enrollment, plan options, and claims resolution.

•Provides quality customer service through a demonstrated understanding of customer needs and timely response to inquiries

•Processes correspondence and complaints on the more difficult or sensitive items in accordance with government regulations, contract provisions and internal procedures and controls

•Researches and obtains resolution to a variety of complicated customer complaints and issues

•Maintains current knowledge of assigned product(s), processing systems, internal controls and related state and federal regulations

•Monitors service activity and maintains detailed documentation regarding inquiries.

•Interacts with other departments to resolve issues as necessary

•Assists in identifying quality and service problems and provides input to corrective action.

•Processes various incoming forms from Nationwide associates (such as beneficiary forms, change of address forms, etc)

•May train less experienced Representatives. Assists them in responding to customer inquiries.

EDUCATION

Master of Science in Criminal Justice Administration May 2005

Tiffin University

Bachelor of Arts in Criminology and Criminal Justice June 1997

Ohio State University

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