Chasity McLane
Garland,TX
Summary
Experienced Claims, Underwriter, and Insurance Analyst bringing 10 years of success in claim and underwriting positions. Eager to take on new roles with long-term growth and advancement potential. Dynamic problem solver with first-rate skills in building relationships and resolving problems. Currently enrolled at the University of Dallas, securing the Securities Industry Essentials (SIE) certification and the Series 7 and Series 63 certifications for the Financial Industry Regulatory Authority (FINRA).
Overview
13
13
years of professional experience
Work History
Claims Analyst
State Farm
10.2021 - 10.2023
- Investigated on average 20 property claims a day with coverage issues that required in-depth investigation, policy interpretation, and knowledge of state statutes and case law, such as those including applicable exclusions or endorsements
- Reduced claims processing time by implementing efficient analytical techniques and strategies.
- Maintained strong working relationships with third-party vendors, such as independent adjusters and appraisers, to facilitate prompt resolution of claims.
- Sought opportunities to streamline workflows and implement process improvements within the claims department, resulting in increased efficiency and productivity levels.
- Worked closely with legal counsel when necessary during complex cases involving litigation or arbitration proceedings related to disputed claim outcomes.
- Escalated claims back to management that were high-value declinations to discuss possible recourse
- Notified the involved parties of claim filings and rejected claims and communicated with the claimants the best course of action to mitigate losses
- Completed investigation by securing recorded statements of the parties, police reports, and estimates, scene investigations, and supporting evidence
- Compiled comprehensive claim analyses for monthly reporting to clients
- Conducted material misrepresentation investigations and submitted findings to Underwriting
- Investigated and determined liability for claims requiring in-depth investigation and analysis including losses with comparative negligence
- Disputed invalid claim resolutions to overturn declination and negotiate claim payments
- Negotiated timely settlements and communicated detailed findings to the claimants.
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
- Participated in ongoing training programs to stay current on industry developments and maintain a strong understanding of relevant laws and regulations affecting the claims process.
Personal Property Claims Adjuster
DIMONT & ASSOCIATES
06.2021 - 10.2021
- Investigated, evaluated evidence to confirm liability, damages, coverages, and possible avenues of recovery
- Remained in constant communication with claimants and professionals throughout the entire claim process
- Flagged and reported possible fraud claims to the SIU team for further review
- Stayed within compliance and state insurance/company guidelines at all times
- Explained benefits, coverages, liability findings, and applicable subrogation laws and regulations either verbally or in writing in compliance with regulatory and statutory requirements
- Issued estimates and settlements within designated authority to customers within the claim deadline.
- Enhanced customer satisfaction with prompt communication and consistent follow-up on claim status updates.
- Prepared reports of findings of investigations.
- Improved overall department performance metrics by consistently meeting or exceeding goals related to cycle time, productivity levels, and customer satisfaction ratings.
- Reduced company expenses by accurately determining coverage and negotiating cost-effective settlements with policyholders.
- Managed high caseloads effectively by prioritizing tasks based on complexity and urgency of claims.
- Maintained compliance with state regulations and company guidelines through diligent adherence to policies and procedures.
- Assisted policyholders with understanding their coverage, providing clear explanations on policy terms and conditions throughout the claims process.
- Coordinated with other departments as needed to support claim resolution efforts, including working closely with underwriting teams to address policy-related questions or concerns.
- Expedited claim resolutions by working closely with legal teams when necessary to resolve disputed cases or potential litigation issues.
Mortgage Underwriter
Digital Risk
10.2020 - 08.2021
- Performed complete and in-depth review of mortgage loan files including income, assets, credit, and collateral
- Responsible for understanding and reviewing customers' credit collateral and ability to repay
- Analyzing loan risk and requesting additional information as necessary
- Making loan eligibility decisions and approving or rejecting applications
- Ability to identify and or clear red flags and alerts
- Assisted Processors\Loan Officers in understanding underwriting decisions and conditions
- Evaluated and ensured overall loan documents are accurate, complete, and compliant.
- Identified possible fraud risks through meticulous evaluation of application materials, protecting both lenders and homebuyers from potential losses.
Claims Representative
Adroit Health Group
10.2018 - 11.2019
- Communicated with previous clients and customers to request payment and arrange payment plans
- Negotiated settlement of claims within designated authority
- Communicated claim activity and processed with the claimant and the client
- Reported claims to the excess carrier and responded to requests of directions in a professional and timely manner
- Alerted Supervisor and Special Investigations Unit to potentially suspect claims
- Responded to all requests for information and inquiries in a detailed and timely manner.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Collaborated with cross-functional teams to expedite complex claims investigations and resolutions.
- Minimized financial losses by identifying fraudulent claims through thorough analysis and investigation.
Customer Service Representative
Guardian Life
01.2016 - 07.2017
- Handled customer inquiries via phone, chat, and email with a focus on first-call resolution
- Ensured customer satisfaction by addressing concerns and resolving issues promptly
- Ensured legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations
- Navigated and utilized various systems to access and update customer information.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Analyzed customer service trends to discover areas of opportunity and provide feedback to management.
- Improved communication between departments by facilitating interdepartmental meetings focused on problem-solving strategies for common issues affecting customers'' experiences.
Medical Claims Analyst
Cigna Insurance Companies
06.2010 - 01.2016
- Assisted the claim managers with developing plans to address disabilities and return to work programs along with physicians, vocational rehab counselors, and employers
- Assessed each applicant's medical history and establishing if they have any preexisting conditions
- Responded to all requests for information and inquiries in a detailed and timely manner
- Successfully documented and added necessary related contacts and interested parties to claim files
- Operated a multi-line telephone switchboard, answering and transferring inbound calls to the appropriate areas to ensure that the customer received the correct information about their need.
- Participated in cross-functional teams to develop strategies for improving overall department performance metrics.
- Managed high-volume caseloads for optimal productivity while maintaining strict attention to detail.
- Improved customer satisfaction by resolving complex medical claims in a timely and professional manner.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
Education
No Degree - Business And Managerial Economics
The University of Texas At Dallas
Richardson, TX05.2027
Diploma -
Plano East Senior High School
Plano, TX05.2006
Skills
- Microsoft Office
- Microsoft Word
- Microsoft Powerpoint
- Microsoft Exchange
- Microsoft Excel
- Xactimate
- SAP S/4HANA
- Ellie Mae
- AllRegs
- LPS
- AWD
- AUS
- AS400
- SHAW
- EDGE
- Encompass
- CORE
- QAS
- Visio
- ECS
- Microsoft SQL Server
- LexisNexis
- Slack
- Zendesk
- Certified Claims Professional (CCP)
Timeline
Claims Analyst
State Farm
10.2021 - 10.2023
Personal Property Claims Adjuster
DIMONT & ASSOCIATES
06.2021 - 10.2021
Mortgage Underwriter
Digital Risk
10.2020 - 08.2021
Claims Representative
Adroit Health Group
10.2018 - 11.2019
Customer Service Representative
Guardian Life
01.2016 - 07.2017
Medical Claims Analyst
Cigna Insurance Companies
06.2010 - 01.2016
No Degree - Business And Managerial Economics
The University of Texas At Dallas
Diploma -
Plano East Senior High School
Similar Profiles
ALBERTO ESCOBAR RUIZALBERTO ESCOBAR RUIZ
Claim Specialist; and Producer at State Farm Corporate & State Farm AgencyClaim Specialist; and Producer at State Farm Corporate & State Farm Agency
Bethany GandyBethany Gandy
Insurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State FarmInsurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State Farm
Blake EnosBlake Enos
Underwriting Service Assistant at State FarmUnderwriting Service Assistant at State Farm
Hadiya HullHadiya Hull
Claims Adjuster at State FarmClaims Adjuster at State Farm
Son HuynhSon Huynh
Medical Surgical Nurse at Medical City of Las ColinasMedical Surgical Nurse at Medical City of Las Colinas