Case Manager I, Claims Management

Walmart • Bentonville, AR

132d • $60,000 - $110,000

About The Position

The Case Manager I is responsible for investigating, evaluating, and resolving low complexity workers' compensation or general liability claims. Our Claims Management team is dedicated to delivering fair, timely, and empathetic resolution of these claims, ensuring compliance with all regulatory requirements. We operate collaboratively, leveraging expertise and strategic initiatives to drive claim resolution and support injured associates and customers throughout the process.

Requirements

• High School Diploma or GED required.
• Strong organizational skills and the ability to manage time effectively in a fast-paced environment.
• Excellent verbal and written communication skills.
• Prior claims, insurance, or customer service experience is preferred.

Nice To Haves

• Bachelor's degree OR 2 years' experience in insurance claims or related area.
• Experience in settling claims and customer service.

Responsibilities

• Secure and maintain the required licensure required by the state(s).
• Manage an active caseload of up to 140 low complexity workers' compensation or general liability claims.
• Secure and review initial claim reports, gather information, facts, and evidence to determine compensability or negligence in accordance with state specific statutes.
• Identify and escalate potential fraudulent claims.
• Identify and escalate claims with Early Claims Assessment (ECA) potential.
• Communicate with injured associates or customers that have sustained minor bodily injury or property damage with empathy and help them navigate the claims process.
• Establish timely and accurate reserves on claims; escalate claims to the Claims Manager if claim value exceeds reserve authority.
• Adjudicate claims within reserve authority up to $35,000; Payment authority $2,500.
• Authorize and approve payment for reasonable and related medical treatment or damages.
• Negotiate and resolve claims with associates and customers.
• Issue settlement payments within authority limit; escalate claims to the Claims Manager if payment exceeds authority.
• Escalate claims with increasing complexity or litigation potential to the Claims Manager.
• Meet or exceed goals on key performance metrics.
• Ensure compliance with all regulatory, jurisdictional, and internal standard operating procedures.
• Deliver exceptional customer service to injured associates, customers, the employer, and clients.
• Pass the adjuster licensing exam and obtain the state-issued adjuster license within required deadlines.

Benefits

• Competitive pay and performance-based bonus awards.
• Health benefits including medical, vision, and dental coverage.
• Financial benefits including 401(k), stock purchase, and company-paid life insurance.
• Paid time off benefits including PTO, parental leave, family care leave, bereavement, jury duty, and voting.
• Short-term and long-term disability.
• Company discounts.
• Military Leave Pay.
• Adoption and surrogacy expense reimbursement.
• Live Better U education benefit program for associates.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: General Merchandise Retailers
• Education Level: High school or GED