DONNA M. JONES

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

Denver, PA **517

717-***-**** (H)

717-***-**** (C)

EDUCATION

TEMPLE UNIVERSITY, Philadelphia PA BA May 1995 Criminal Justice Major Cum Laude

G.P.A. 3.45 (overall); 3.9 (Major)

Honors/Activities:

Kohn Foundation Scholarship, Hymen Ruben Scholarship, Dean’s List, Golden Key National Honors Society, Pre-Law Society

EXPERIENCE

CNA INSURANCE, Wyomissing PA 01/19 - Present

Auto Claims Adjuster

-Investigates and maintains commercial auto claims

-Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals, and negotiates and settles claims

-Sets activities, reserves and authorizes payments within scope of authority

-Ensures issuance of disbursements while managing loss costs and expenses

-Coordinates and performs investigations and evaluates claims through contact with insureds, claimants, business partners, witnesses and experts

-Identifies files that have potential fraud for SIU

-Identifies claims with third party recovery potential and coordinates with subrogation

-Responsible for input of data that accurately reflects claim circumstances and other information important to business outcomes

COMMONWEALTH OF PENNSYLVANIA 10/16-10/18

Income Maintenance Case Worker

-Communicated on a continuous basis with clients and other members of the public by responding promptly and professionally to incoming telephone calls

-Utilized Genesys telephone system to respond to inquiries and process requests received from clients throughout the State of PA

-Authorized changes to the computer database such as, but not limited to, client demographics, adding and removing household members, updating and/or changing social security numbers, updating earned and unearned household income, updating shelter and utility costs

-Verified clients eligibility criteria for Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP) and Medical Assistance (MA) through various Department of Welfare (DPW) and Office of Income Maintenance (OIM) policies and procedures set forth by the state of PA

-Researched policy to answer client inquiries or handle complaints promptly and accurately

-Promptly identified client needs and identified the appropriate action to be taken

-Explained DPW/OIM policies and procedures to clients as it relates to changes in their benefits and services

-Interviewed clients via telephone for the purpose of determining and explaining eligibility and requirements for ongoing DPW programs and services

-Responsible for disseminating information to clients who called regarding community services and resources such as food banks, emergency shelters, housing, etc.

-Notified clients of eligibility/ineligibility of benefits and services including next courses of action

-Performed routine case maintenance

-Controlled and followed up on information and contact with clients to address needs and concerns

-Maintained timely electronic ticket file

-Utilized the language line for non-English speaking clients

-Remained current on constant policy changes

***TIME OFF TO RAISE FAMILY 01/07 – 10/16

TRAVELERS INSURANCE, Wyomissing PA 04/04 – 01/07

Subrogation Claims Representative

- Reviewed letters of inquiry to determine accident information and update claims system to reflect submitted information

- Reviewed member claims history to ensure accurate processing of claims based on submitted information

- Resolved claim system edits and updated coordination of benefits information on claims

- Evaluated information to determine liability related to subrogation, third party, and Workers Compensation

- Ensured accurate documentation of file activities and steps needed to resolve claims

- Maintained excellent follow-up to ensure maximized recoveries were achieved

- Maintained accurate and up-to-date case files

- Coordinated benefits with other carriers

- Provided status updates and resolved customer inquiries to insureds, providers, other carriers, and attorneys as needed

- Coordinated subrogation cases with legal department and external attorneys

TRAVELERS INSURANCE, Wyomissing PA 04/02 – 04/04

Workers Compensation Claims Representative

-Performed telephonic case management of Workers Compensation claims

-Contacted injured workers, employers and medical providers in a timely manner to gather relevant information to assist in the investigation and evaluation of the claim

-Managed to conclusion all questionable workers compensation claims

-Managed files with an emphasis on file quality including timely contact and proper documentation, maximizing internal resources, and achieving a positive end result

-Aggressively pursued claim resolution opportunities

-Built strong partnership with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services to the injured worker

-Identified claim issues as they arose, and took appropriate steps to resolve them or refer them to the Unit Manager for reassignment

-Established appropriate reserves to reflect claim exposure

COURT OF COMMON PLEAS OF LANCASTER COUNTY 05/00 – 04/02

Child Advocate, Victim/Witness Services, Office of the District Attorney

-Provided support, assistance and advocacy to child victims of crime and their families at any stage in the criminal justice system

-Conducted courtroom orientations

-Provided accompaniment to police and district attorney interviews, preliminary hearings, guilty pleas, trials and sentencings

-Arranged for transportation and childcare for court appearances

-Acted as a liaison between the police, prosecutors and victims

-Made referrals for children and their parents to counselors and other appropriate social service agencies

-Assisted victims in filing Crime Victims Compensation claims

-Provided intervention between employees, schools, creditors and victims

-Aided in creating and then coordinated the Lancaster County Kid’s Court project

COURT OF COMMON PLEAS OF LANCASTER COUNTY 02/00 – 05/00

Domestic Relations Conference Officer

-Conducted child and spousal support conferences with plaintiffs, defendants and attorneys

-Reviewed case records, court orders, tax returns, health care coverage and wage/financial information

-Verified information by contacting employers, interviewing parties and reviewing public records

-Calculated support orders by applying Pennsylvania child and spousal support guidelines

OFFICE OF THE DISTRICT ATTORNEY OF PHILADELPHIA 10/98 – 2/00

Law Clerk, Legislation Unit

-Sole support staff in unit of four attorneys

-Facilitated attorneys’ lobbying efforts in the Pennsylvania General Assembly

-Conducted all support work on issues such as Megan’s Law, Commonwealth Right to a Jury Trial, One-Handgun-A-Month and Wiretap Amendments

-Assisted Hiring Chairperson and Hiring Coordinator: scheduled interviews, organized files, resumes and communicated with applicants

-Liaison to Pennsylvania District Attorneys Association (statewide professional association)

-Briefed attorneys on upcoming meeting agendas and compiled information packets

-Tracked House and Senate bills, researched case law and statutes

-Performed all secretarial duties including correspondence, filing, scheduling, answering phones and stocking office supplies

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