Position Summary: The Case Manager I is responsible for investigating, evaluating, and resolving low complexity workers compensation or general liability claims, ensuring compliance with all regulatory requirements and delivering empathetic support to injured associates and customers throughout the claims process.
Key Responsibilities:
- Secure and maintain 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 according to state-specific statutes.
- Identify and escalate potential fraudulent claims and claims with Early Claims Assessment potential.
- Communicate empathetically with injured associates or customers with minor bodily injury or property damage to help them navigate the claims process.
- Establish timely and accurate reserves on claims; escalate claims if reserve authority is exceeded.
- Adjudicate claims within reserve authority up to $35,000; payment authority up to $2,500.
- Authorize and approve payments for reasonable and related medical treatment or damages.
- Negotiate and resolve claims; issue settlement payments within authority limits; escalate as necessary.
- Meet or exceed goals on key performance metrics.
- Ensure compliance with all regulatory, jurisdictional, and internal SOPs.
- Pass the adjuster licensing exam and obtain the state-issued adjuster license within required deadlines.
Qualifications:
- High School Diploma or GED required.
- Insurance Adjuster license or ability to obtain within 30 days of job entry date.
- Strong organizational, verbal, and written communication skills.
- Prior claims, insurance, or customer service experience preferred.
- Bachelor's degree or 2 years experience in insurance claims or related area preferred.
Benefits:
Competitive pay ($60,000.00-$110,000.00 annual), performance-based bonuses, health benefits (medical, vision, dental), financial benefits (401(k), stock purchase, company-paid life insurance), paid time off including sick leave, parental leave, and more.
Location: 608 SW 8th St, Bentonville, AR 72712-6207, USA.
