Case Manager I, Claims Management

Case Manager I - Claims Management

Our Claims Management team is dedicated to delivering fair, timely, and empathetic resolution of workers' compensation and general liability 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.

The Case Manager I is responsible for investigating, evaluating, and resolving low complexity workers' compensation or general liability claims.

What you'll do

Claims Management

• 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.

What you'll bring

At Walmart, we offer competitive pay as well as performance-based bonus awards and other great benefits for a happier mind, body, and wallet. Health benefits include medical, vision and dental coverage. Financial benefits include 401(k), stock purchase and company-paid life insurance. Paid time off benefits include PTO (including sick leave), parental leave, family care leave, bereavement, jury duty, and voting. Other benefits include short-term and long-term disability, company discounts, Military Leave Pay, adoption and surrogacy expense reimbursement, and more.

You will also receive PTO and / or PPTO that can be used for vacation, sick leave, holidays, or other purposes. The amount you receive depends on your job classification and length of employment. It will meet or exceed the requirements of paid sick leave laws, where applicable.

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.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to a specific plan or program terms.

The annual salary range for this position is $60,000.00-$110,000.00. Additional compensation includes annual or quarterly performance bonuses. Additional compensation for certain positions may also include :

Minimum Qualifications : Insurance Adjuster license OR will obtain an Insurance Adjuster license within 30 days of job entry date.

Preferred Qualifications : Bachelor's degree OR 2 years' experience in insurance claims or related area, Settling claims and customer service