Hilah Adkins
Summary
Competent in adjudicating claims thoroughly. Proficient in making coverage and liability decisions, documenting actions, and identifying suspect claims. Highly organized and proactive with excellent communication and problem-solving skills. Senior Claims Representative with 32 years of industry experience. Successful at meeting customer and company needs with fair and equitable approach to claims process. Detail-oriented, systematic, and skilled in identifying exposures and proposing actionable solutions.
Overview
32
32
years of professional experience
1
1
Certification
Work History
Sr. Claims Representative
Accident Fund Insurance Company
Lansing
07.2006 - 12.2025
- Held a position as a Sr. Claims Examiner – Central Region.
- Duties include handling of all aspects of Workers' Compensation claims from open to close.
- Currently handle Missouri and Kansas but assist in many others states for various regions.
- I have handled 18 various states throughout my career.
- Knowledge of settlement negotiations, all aspects of investigation of claims, process temporary total disability benefits, recorded statements, reporting of fraud to the state and medical supervision for the care of the injured worker.
- Complete licensing and seminars annually for Florida as well as South Carolina and complete site visits at a minimum of one time per year.
- Training new hires and Medical only representatives for career advancement.
- Complete audits for Medical Only representative, cover for manager when out of the office, lead special projects.
- Organize and facilitate settlement days with our St. Louis Workers Compensation Judges twice a year.
- Track various audit criteria for the team for year end status reporting.
Claims Representative III
Sedgwick
12.2005 - 07.2006
- Held a position as a Claims Examiner III for a major Hospital Organization in Florida, Alabama and Wisconsin.
- Held licensing in TX, CT, FL, MI and GA.
- Duties include handling of all aspects of Workers' Compensation claims from open to close.
- Knowledge of settlement negotiations, all aspects of investigation of claims, process temporary total disability benefits, recorded statements, reporting of fraud to the state and medical supervision for the care of the injured worker.
- Completed licensing and seminars annually for all states and complete site visits at a minimum of one time per year.
Litigation Specialist
AIG
04.2002 - 12.2005
- Handled 300 files for Kansas, Nebraska, Iowa, Missouri and Illinois.
- Responsible for handling the litigation of these files.
- Files were transferred once they were ready for settlement, hearings or trials.
- Responsible to negotiate or defend the cases with assistance of defense counsel.
- Also handled all employee claims from beginning to end.
Education
Associates of Business management -
University of Phoenix
Lutheran High School South -
Lutheran High School South
Skills
- Excel
- Word
- Powerpoint
- Guidewire Clam Center
- Optum
Certification
- Certified Authority on Workers’ Compensation Designation - CAWC, Accident Fund Insurance Company of America, 11/01/22, No Expiration Date
- South Carolina Adjuster License, 06/01/15
- Florida Adjusters License, 01/01/06