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Walmart

Sells groceries and essentials in stores and online

Case Manager I - Claims Management

Claims AdjudicationUpdated on Nov 9
Full-timeBentonville, AR, USA$60k - $110k /yr

About the Job

Requirements

  • Secure and maintain the licensure required by the state(s).
  • Pass the adjuster licensing exam and obtain the state-issued adjuster license within required deadlines.
  • Have a high school diploma, GED, or equivalent, or meet the alternative qualification of two years’ experience in claims processing, insurance operations, or customer-facing service roles.
  • Have strong organizational skills and the ability to manage time effectively in a fast-paced environment.
  • Have excellent verbal and written communication skills.

Responsibilities

  • 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 potential.
  • Communicate empathetically with injured associates or customers who have sustained minor bodily injury or property damage, 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, with payment authority up to $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 limits; 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 regulatory, jurisdictional, and internal standard operating procedures.
  • Deliver customer service to injured associates, customers, the employer, and clients.

Desired Qualifications

  • Prior claims, insurance, or customer service experience.
  • Certification in claims management or insurance, such as AIC certification.
  • Prior experience applying jurisdiction-specific regulatory requirements and in negotiation and settlement processes.

About the Company

Walmart

Sells groceries and essentials in stores and online

Walmart sells groceries, household essentials, clothing, and electronics through stores and online marketplaces for consumers around the world. Its everyday low price model combines large purchasing volumes with distribution networks that move goods to stores and customer homes. Shoppers can browse online, collect orders at a nearby store, or request delivery, while third-party merchants use its marketplace and fulfillment services to reach customers. The group earns revenue from merchandise sales, memberships, advertising, and services, and also operates pharmacies, optical centers, and digital payments businesses. Walmart opened its first discount store in 1962 and is headquartered in Bentonville, Arkansas.

Company size
10,001+
Company stage
IPO
Headquarters
Bentonville, AR
Founded
1962

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