Chantel McDonald
Austell
Summary
Dedicated professional skilled in claims processing and documentation. Known for investigating discrepancies and effectively communicating with customers. Eager to leverage expertise in claims management to enhance operational efficiency and client satisfaction.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Licensed Claims Associate
State Farm Insurance
Dunwoody, GA
10.2023 - Current
- Use ECS to process and support auto total loss claim activities, maintaining accurate documentation.
- Evaluate and process claims while ensuring compliance with company policies and state regulations.
- Collaborate with customers and internal teams to gather information for accurate claim assessments.
- Track and document claim status efficiently using claims management software/workflows.
- Investigate discrepancies in claim documentation and coordinate with appropriate teams to resolve issues promptly.
- Apply knowledge of policy contracts and applicable rules to support total loss handling within approved limits.
- Coordinate rental car and towing services and assist with move coordination of total loss vehicles via salvage assignments.
- Secure and process required title/salvage paperwork and communicate claim updates via phone/email/written correspondence.
Customer/Claims Service Representative
The Home Depot
Atlanta, GA
03.2022 - 05.2024
- Documented and recorded incoming property damage claim calls in a remote, high call-volume environment, ensuring accuracy and adherence to Home Depot procedures.
- Collaborated with customers to gather necessary information for accurate claim assessments and timely follow-up.
- Submitted complete claim information to the appropriate department, and supported next-step processing.
- Tracked and updated claim details/status through internal systems to maintain efficient case movement and accurate records.
- Investigated call/file discrepancies and coordinated with relevant parties to resolve issues promptly.
- Responded to customer inquiries using phone and email; scheduled service calls for insurance-related claims.
AARA — Medical Receptionist
Family Arthritis Center
Loxahatchee, FL
02.2018 - 06.2021
- Verified insurance benefits and processed insurance verification/pre-authorization requests using CareCloud, supporting timely patient care.
- Managed patient scheduling and appointment coordination to optimize clinic workflow.
- Maintained accurate electronic health records and documentation in compliance with HIPAA regulations.
- Communicated effectively with patients, addressing inquiries and resolving concerns promptly.
- Collaborated with patients and providers to gather needed information for referrals and specialist visits.
- Processed payments and maintained accurate records for balances due at time of visit.
- Processed medical record requests and subpoenas with proper documentation and follow-up procedures.
Claims Specialist
First Notice Systems
Springfield, MA
04.2017 - 02.2018
- Documented and recorded incoming Bodily Injury, Auto, and Home claim calls with strong attention to detail.
- Managed/investigated and resolved claim-related inquiries; supported the injury portion of insurance claims.
- Gathered and audited medical bills and treatment-related details; submitted information to adjusters for follow-up.
- Reviewed claim losses including police reports and attorney demands to identify complexities and support escalation.
- Promoted to Claims Escalation Team based on performance and accuracy.
Education
Associate of Applied Science - Baking And Pastry Arts
Johnson & Wales University
Miami, FLCertificate - Medical Billing And Coding
Florida Career College
West Palm Beach, FL2018
Skills
- Auto Total Loss file processing/support
- ECS (claims processing) CCC & MBOS familiar
- Claims processing and documentation
- Claims investigation and discrepancy resolution
- Policy interpretation and coverage support
- Evaluating information to support claim assessments
- Applying knowledge of policy contracts and state regulations
- Documenting and tracking claim statuses in claims management systems
- Customer communication via phone, written correspondence, and electronic media
- Task-driven queues, multitasking across technical platforms
- Accountability, resourcefulness, organization, and time management
- Referrals/escalation of out-of-scope claims
Certification
- Licensed Claims Associate - 2023
- NPN: 21043004
Timeline
Licensed Claims Associate
State Farm Insurance
10.2023 - Current
Customer/Claims Service Representative
The Home Depot
03.2022 - 05.2024
AARA — Medical Receptionist
Family Arthritis Center
02.2018 - 06.2021
Claims Specialist
First Notice Systems
04.2017 - 02.2018
Associate of Applied Science - Baking And Pastry Arts
Johnson & Wales University
Certificate - Medical Billing And Coding
Florida Career College