Case Manager II, Claims Management
About The Position
The Case Manager II, Claims Management, plays a critical role in managing complex claims involving bodily injury, personal injury, and property damage. This position requires thorough investigation, analysis of medical and legal information, and coordination with external counsel to minimize legal exposure. The role involves negotiating settlements, managing reserves, and ensuring compliance with company policies. The Case Manager II also supports continuous improvement initiatives, fosters strong stakeholder relationships, and provides guidance to associates, contributing to effective claims resolution and upholding Walmart’s standards of integrity and service excellence. The Claims Management team is dedicated to thorough investigation and resolution of customer claims, focusing on minimizing legal exposure and ensuring accurate case assessments. This team manages complex cases involving bodily injury and property damage by analyzing evidence, medical reports, and applicable laws. Collaborating with internal and external partners, they drive effective claim resolutions while maintaining compliance with company policies and ethical standards. The team fosters continuous learning, accountability, and clear communication to deliver results that support business goals and enhance the customer experience through diligent case management and claims resolution.
Requirements
- Proven experience in managing complex claims involving bodily injury, personal injury, and property damage.
- Strong skills in claims investigation, resolution, and case management with attention to legal and medical report interpretation.
- Ability to coordinate and collaborate with outside legal counsel, investigators, and specialists to support claim outcomes.
- Proficiency in assessing claim impacts on case law and structuring settlements within established guidelines.
- Demonstrated capability in negotiating claim resolutions with claimants and third parties effectively.
- Experience in monitoring and managing claim reserves and authorizing payments within approval limits.
- Commitment to upholding company policies, ethical standards, and fostering a culture of accountability and continuous improvement.
- Option 1: High school diploma, GED, or equivalent and 1 year’s experience in claims management, insurance operations, or related area.
- Option 2: 3 years’ experience in claims management, insurance operations, or related area.
- Current or prior (within last 3 years) Property & Casualty Adjuster License.
Nice To Haves
- Settling claims and customer service
Responsibilities
- Manage complex claims by reviewing medical reports, legal precedents, and case information to determine appropriate resolutions.
- Conduct thorough investigations including interviews, evidence collection, and coordination with specialists to assess claim validity.
- Oversee monetary aspects of claims by establishing reserves, monitoring payments, and facilitating approvals or denials within authority levels.
- Negotiate settlements by presenting investigative findings and legal rationale to claimants and third parties to reach consensus.
- Coordinate with internal and external stakeholders to support claims processes and ensure compliance with company policies.
- Provide guidance and development opportunities to associates, fostering accountability and continuous improvement.
Benefits
- Medical coverage
- Vision coverage
- Dental coverage
- 401(k)
- Stock purchase
- Company-paid life insurance
- PTO (including sick leave)
- Parental leave
- Family care leave
- Bereavement
- Jury duty
- Voting leave
- Short-term disability
- Long-term disability
- Company discounts
- Military Leave Pay
- Adoption and surrogacy expense reimbursement
- PTO and/or PPTO that can be used for vacation, sick leave, holidays, or other purposes.
- Live Better U is a Walmart-paid education benefit program for full-time and part-time associates in Walmart and Sam's Club facilities. Programs range from high school completion to bachelor's degrees, including English Language Learning and short-form certificates. Tuition, books, and fees are completely paid for by Walmart.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
