Oni Mitchell

**** ********** ****

Pennsauken, NJ 08109

609-***-****

acq32y@r.postjobfree.com

Summary

PIP (Personal Injury Protection) Personal /Commercial Liability / Bodily Injury Personal /Commercial

Auto/Material Damage Personal / Commercial

Business Experience

January 2008 to Present

Harleysville Insurance Co. /Nationwide Insurance Co. Mt. Laurel, New Jersey PIP Specialist II

Determine eligibility and explain coverage to injured parties for Personal and Commercial policies.

Determine who qualifies for a PIP settlement and ability to negotiate a monetary offer based on injury sustained.

Review EOB’s (Explanation of Benefits) for approval and payment.

Ability to handle PIP and/or Med Pay claims in multiple states: Northeast, Mid-Atlantic, Southeast, and Mid-West regions.

Defend PIP Arbitrations and Law Suits.

Identify when an IME or Peer Review is necessary.

Coordinate with Medicare and Workers Compensation regarding injuries and its relatedness. Material Damage Specialist II

Settle property damage, collision, and comprehensive coverage claims.

Determine liability.

Defend Arbitrations.

Ability to recognize exposure and refer files to Subrogation and SIU.

Desk review low impact estimates and assign appraisers for mid to heavy damaged vehicles.

Ability to recognize and handle Garage Keepers Claims, Loading/Unloading Claims, Total Loss. April 2003 to January 2008

AAA Midatlantic Insurance Company Marlton, New Jersey Medical Claims Examiner

Handle multi-line files which included property damage/collision, bodily injury & PIP.

Handle medical payments of an insured thru PIP coverage on their auto policy.

Negotiate settlement of medical bills with plaintiff/claimant/provider attorneys.

Identify medical CPT codes, its meaning, and its relation to the accident.

Communicate with insurers, claimants, providers, attorneys daily.

Investigate validity and determine liability of losses.

Negotiate settlement of losses with plaintiff attorneys, and adverse carriers along with their insurers.

August 1999 to March 2003

Ohio Casualty Insurance Co. Voorhees, New Jersey

PIP Claims Representative

Handle single/multiple injury claims per one file, same accident.

Identify when and how to recover subrogation funds.

Communicate with attorneys, providers, insurers, and claimants daily.

Negotiate settlement of losses with plaintiff / claimants, attorneys, and adverse carriers, claimants and insurers.

Classify losses in relation to insurance contract.

Ability to request prior medical records to review in accordance of medical necessity, prior/pre- existing injuries, and relatedness to a claim.

Auto Claims Representative

Handle 1st and 3rd party personal auto & commercial auto claims.

Determine and negotiate percentage of comparative negligence to auto claims.

Respond to and defend arbitrations and law suits filed by adverse carriers.

Ability to identify and handle total loss vehicles.

Provide customer service to insurers, claimants, agents, and repair facilities.

Take recorded statements of insurers, claimants, and witnesses.

Intake of new claims which were reported.

Handle multiple tasks involving customer service and projects. Education

2013 Camden County College Camden, New Jersey – Associates Degree Skills

P & C Licenses in the following states: RI, DE, CT, SC, NC, GA and NH Customer service – answering and making phone calls (Customer Service Award Winner) Employee training

Team Leadership

United Way Chairperson

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