Case Manager II, Claims Management

Position 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, establishing reserves, and adjudicating claims within financial authority. The position requires coordinating medical treatment authorization, calculating indemnity payments, and negotiating resolutions to achieve timely outcomes. The Case Manager supports strategic initiatives to enhance claim resolution, ensures compliance with regulatory standards, and collaborates with stakeholders to deliver exceptional service while maintaining required licensure and upholding company policies and ethical standards. About the team: The WCS team manages delivery claims by conducting thorough investigations, timely adjudication, and effective resolution of low-complexity claims. Team members ensure accurate documentation and regulatory compliance while collaborating with internal and external partners to support claimants. They maintain financial reserves within authority limits and apply strong negotiation and risk-management skills. Emphasizing clear communication and professional engagement, the team continuously improves processes to deliver consistent service quality. Their efforts contribute to efficient claims processing aligned with company standards and values, fostering reliable and accountable claims management. What you’ll do: Review and analyze initial claim reports to determine compensability in accordance with jurisdictional statutes. Manage a caseload of mid-complexity workers’ compensation or general liability claims throughout the claim lifecycle. Establish and adjust reserves within authority limits, escalating cases exceeding thresholds. Authorize and monitor medical treatments to ensure necessity and compliance with guidelines. Calculate wages and issue indemnity payments per jurisdictional requirements. Communicate with claimants to facilitate understanding of the claims process. Negotiate and resolve claims to achieve timely and appropriate outcomes. Prepare and present claims for review to secure settlement authority or refine strategies. Maintain required licensure and ensure compliance with regulatory and internal procedures. What you’ll bring: Proven experience managing mid-complexity workers’ compensation or general liability claims throughout the claim lifecycle. Strong skills in claims investigation, resolution, and case management aligned with jurisdictional statutes. Ability to establish accurate reserves and adjudicate claims within assigned financial authority. Knowledge of medical treatment authorization processes using Official Disability Guidelines and nurse resources. Active or recently held Property & Casualty Adjuster License. Effective communication and negotiation skills with associates, customers, and legal representatives. Commitment to compliance with regulatory and internal policies while delivering exceptional 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. 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 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 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. Bachelor’s degree in Risk Management, Insurance, Business Administration, Legal Studies, or related field. experience in settling claims and customer service., Industry designations (e.g., AIC, WCCP). Primary Location 905 Customer Dr, Bentonville, AR 72716, United States of America Walmart and its subsidiaries are committed to maintaining a drug‑free workplace and has a no tolerance policy regarding the use of illegal drugs and alcohol on the job. This policy applies to all employees and aims to create a safe and productive work environment. #J-18808-Ljbffr Walmart