Donna Marie Raspa
Bayville,NJ
Summary
Detail-oriented PIP Claims Adjuster with 15 years of subrogation experience. Expertise in determining liability and assessing vehicle damages. Proven track record of delivering accurate claims determinations and maintaining effective communication throughout the process.
Overview
25
25
years of professional experience
1
1
Certification
Work History
PIP Claims Adjuster
NJM Insurance Group
Parsippany , NJ
12.2000 - Current
- Reviewed PIP coverages, identifying issues and analyzing loss events for coverage determinations.
- Evaluated claims for fraud indicators and underwriting issues, processing necessary referrals.
- Maintained communication with involved parties to deliver relevant determinations throughout claim process.
- Documented all actions taken during claims concisely and accurately for compliance.
- Managed requests for medical treatment, equipment, and peer reviews; communicated determinations within three business days.
- Requested Independent Medical Examinations and made determinations on additional treatment or benefits termination.
- Established and adjusted medical and non-medical benefits reserves throughout claim life cycle.
- Calculated and issued non-medical benefits, including wages and essential services.
Subrogation Adjuster
NJM Insurance Group
Parsippany, New Jersey
02.2004 - 09.2019
- Reviewing claim files to determine liability and potential recovery opportunities.
- Investigating the circumstances surrounding losses and gathering information from various parties.
- Communicating with other insurers, claimants, witnesses, and legal professionals to negotiate settlements.
- Documenting findings and drafting demand letters.
- Managing a caseload using specialized claims software and maintaining quality claim files.
- Case Preparation/Represntation at Arbitration: prepare files for arbitration for recovery from other insurance companies and represent these files for NJM.
Education
Bachelor of Science - Nursing
Bloomfield College
Bloomfield, NJ05-1999
Skills
- Customer service
- Verbal and written communication
- Active listening
- Highly motivated
- Time management
- Claims investigation
- Coverage assessments
- Automobile claims specialist
- Settlement negotiation
- Damage assessment
Certification
- Notary Public
- Arbitrator for Arbitration Forums
References
References available upon request.
Timeline
Subrogation Adjuster
NJM Insurance Group
02.2004 - 09.2019
PIP Claims Adjuster
NJM Insurance Group
12.2000 - Current
Bachelor of Science - Nursing
Bloomfield College