• Determine compensability and extent of coverage on assigned claims. • Conduct thorough investigations, including interviews with employees, employers, and witnesses. • Obtain and review medical, hospital, police, employment, and other relevant records. • Manage EDI reporting and CMS Section 111 compliance. • Utilize approved preferred vendors and cost-containment resources. • Prepare comprehensive and accurate reports for clients and excess carriers. • Negotiate settlements with claimants and/or their attorneys. • Manage litigation strategy, legal vendors, and associated costs in accordance with account requirements. • Handle catastrophic losses, complex litigation files, and other sensitive matters. • Respond to client inquiries promptly and professionally. • Maintain required adjuster licensing and continuing education. • Stay current on jurisdictional regulations, industry trends, and best practices. • Mentor, train, and share technical expertise with team members as needed. • Perform additional duties as assigned.