Claims Case Manager
2 weeks ago
Applicants must reside within commuting distance of the primary job location:
702 SW 8TH ST, BENTONVILLE, AR 72716, United States of America
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 files 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 the 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.
Minimum qualifications:
- Insurance Adjuster license OR will obtain an Insurance Adjuster license within 30 days of the job entry date.
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