Case Manager I, Claims Management

About Walmart:

Fifty years ago, Sam Walton started a single mom-and-pop shop and transformed it into the world's biggest retailer. Since those founding days, one thing has remained consistent: our commitment to helping our customers save money so they can live better. Today, we're reinventing the shopping experience and our associates are at the heart of it. You'll play a crucial role in shaping the future of retail, improving millions of lives around the world. This is that place where your passions meet purpose. Join our family and create a career you're proud of.

Are you ready to manage complex claims and make a tangible impact? As a Case Manager, you’ll take charge of resolving claims, mitigating legal risks, and collaborating with top professionals in the field. If you're passionate about conducting thorough investigations and negotiating outcomes, this is the role for you!
 

What you'll do...

• Leads claim investigations by conducting ongoing medical and legal reviews; commissioning field investigators, reconstructionists, and cause and origin specialists to determine claim origination; managing media exposure during investigations; synthesizing information from outside counsel; and reviewing, documenting, and indexing information received on each claim in the claim/image management system.
• Handles monetary aspects of assigned claims by establishing reserves within approval level; notifying store managers of significant reserve increases; monitoring reserves for all open claims; authorizing payment for approval or facilitating denial of the claim; and reserving file for payments that exceed authority for manager and serious case review.
• Minimizes legal exposure by securing services of outside legal counsel; attending and participating in arbitrations; auditing and paying outside counsel invoices; assessing the impact claim may have on case law and precedent prior to making claim payment; and structuring complex settlements.
• Manages moderately complex cases involving alleged bodily injury, personal injury, and property damage by interviewing key witnesses; securing evidence; analyzing evidence; reviewing applicable laws; interpreting medical reports; deducing causes and responsibilities; documenting case details; determining whether payment is warranted; and managing multiple claims related to a single event as required.
• Manages interpretation of medical reports and case information; reviewing records for preexisting conditions; referencing applicable case law/statutes; and presenting claim reviews and decisions to senior management for approval or guidance.
• Manages negotiations with customer, customer's attorney or third party to resolve claims by sharing investigative results and rationale; listening to claimant perspective and arguments; influencing claimant's perspective; and coming to consensus on appropriate and final resolution.
• Coordinates completes, and oversees job-related activities and assignments by developing and maintaining relationships with key stakeholders; supporting plans and initiatives to meet customer and business needs; identifying and communicating goals and objectives; building accountability for and measuring progress in achieving results; identifying and addressing improvement opportunities; and demonstrating adaptability and promoting continuous learning.
• Provides supervision and development opportunities for associates by hiring and training; mentoring; assigning duties; providing recognition; and ensuring diversity awareness.
• Ensures compliance with company policies and procedures and supports company mission, values, and standards of ethics and integrity by implementing related action plans; utilizing and supporting the Open Door Policy; and providing direction and guidance on applying these in executing business processes and practices.

Leadership Expectations

Respect for the Individual: Demonstrates and encourages respect for others; drives a positive associate and customer/member experience for all; embraces differences in people, cultures, ideas, and experiences; supports workplaces where associated feel seen and connected through a culture of belonging, so all associates thrive and perform; contributes to an environment allowing everyone to bring their best selves to work.

Respect for the Individual: Demonstrates engagement and commitment to the team, developing others through feedback, coaching, mentoring, and developmental opportunities; and recognizes others’ contributions and accomplishments.

Respect for the Individual: Builds strong and trusting relationships with team members and business partners; works collaboratively to achieve objectives; communicates with impact and listens attentively to a range of audiences; and demonstrates energy and positivity for own work.

Acts with Integrity: Maintains and promotes the highest standards of integrity, ethics and compliance; models the Walmart values and leads by example to foster our culture; supports Walmart’s goal of becoming a regenerative company by making a positive impact for associates, customers, members, and the world around us.

Acts with Integrity: Follows the law, our code of conduct, and company policies, and encourages others to do the same; supports an environment where associates feel comfortable sharing concerns; reinforces our culture of non-retaliation; listens to concerns raised by associates and takes action; acts with accountability for achieving results in a way that is consistent with our values.

Acts with Integrity: Is consistently humble, self-aware, honest, and transparent.

Service to the Customer/Member: Delivers results while putting the customer/member first and applying an omni-merchant mindset and acts with an Every Day Low Cost mindset to drive value and Every Day Low Prices for customers/members.

Service to the Customer/Member: Adopts a broad perspective that considers data, analytics, customer/member insights, and different parts of the business when making plans.

Strive for Excellence: Consistently raises the bar and seeks to improve; demonstrates curiosity and a growth mindset; seeks feedback, asks thoughtful questions; supports innovation and intelligent risk-taking; and exhibits resilience in the face of setbacks.

Strive for Excellence: Implements and supports continuous improvements and willingly embraces new digital tools and ways of working.

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.

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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.

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For information about PTO, see https://one.walmart.com/notices.

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

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

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.

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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.

‎

For information about PTO, see https://one.walmart.com/notices.