Position Summary...What you'll do...Role summary: The (USA) Case Manager II, Claims Management, is responsible for managing mid-complexity workers' compensation and general liability claims throughout the claim lifecycle. This role involves reviewing claim reports, determining compensability, authorizing medical treatment, and negotiating resolutions while ensuring compliance with regulatory standards. The position requires establishing accurate reserves, escalating cases as needed, and collaborating with stakeholders to achieve timely outcomes. The Case Manager II also supports strategic initiatives to improve claim resolution and provides expert guidance to enhance operational effectiveness, maintaining a strong focus on integrity, customer service, and continuous improvement.
About the team: The team manages customer accident claims for Walmart and Sam's Club with a strong focus on integrity, accountability, and collaboration. They handle claims investigations, resolution, and case management while ensuring compliance with policies and regulations. This group supports continuous improvement and upholds Walmart's core values by delivering timely, accurate outcomes. Members mentor and develop associates to meet performance goals and reduce litigation exposure. The team fosters strong partnerships across the organization, maintaining a supportive environment dedicated to exceptional service and effective risk management.
What you'll do: - Review and analyze claim reports to determine compensability and identify potential fraud indicators.
- Manage mid-complexity workers' compensation and general liability claims throughout the claim lifecycle.
- Establish and adjust reserves within authority limits, escalating cases as necessary.
- Authorize and monitor medical treatments to ensure appropriateness and compliance with guidelines.
- Calculate wages and process indemnity payments according to jurisdictional requirements.
- Communicate effectively with claimants and stakeholders to facilitate claim resolution.
- Negotiate settlements and present claims in review meetings to secure approvals.
- Maintain compliance with regulatory standards and company policies.
- Provide expert guidance and support to improve claim management processes.
What you'll bring: - Proven experience managing mid-complexity workers' compensation or general liability claims throughout the claim lifecycle.
- Strong skills in claims investigations, resolution, and case management with attention to regulatory compliance.
- Ability to establish accurate reserves and adjudicate claims within assigned financial authority.
- Proficiency in authorizing and monitoring medical treatment aligned with Official Disability Guidelines.
- Effective communication and negotiation skills to resolve claims with stakeholders.
- Demonstrated mentorship and coaching capabilities to support team development.
- Commitment to integrity, ethics, and adherence to company policies and legal standards.
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.
For information about PTO, see https://one.walmart.com/notices.
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.
For information about benefits and eligibility, see One.Walmart.
The annual salary range for this position is $70,000.00 - $130,000.00
Additional compensation includes annual or quarterly performance bonuses.
Additional compensation for certain positions may also include :
- Stock
ㅤ
ㅤ
ㅤ
ㅤ
Minimum Qualifications...Outlined below are the required minimum qualifications for this position. If none are listed, there are no minimum qualifications.
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.
Preferred Qualifications...Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications.
Settling claims and customer service
Primary Location...608 Sw 8Th St., Bentonville, AR 72712-6207, United States of America
