Job Summary
This role focuses on delivering high quality customer service in a work from home model for an international organization that manages workers compensation claims. The specialist handles complex insurance claim inquiries supports Spanish speaking customers and ensures fair and timely resolution.
Responsibilities
- Handle end to end workers compensation claim inquiries by responding to customers in a timely and empathetic manner while maintaining high service quality standards.
- Manage inbound and outbound interactions through multiple communication channels while ensuring every customer contact is accurately documented and resolved.
- Coordinate with internal claims teams to gather necessary information on open cases while ensuring that all claim details are up to date and compliant with process guidelines.
- Analyze claim information such as incident narratives medical documents and wage details while identifying gaps or discrepancies that require further clarification.
- Provide clear and understandable explanations of policy coverage claim status and next steps to workers employers and other stakeholders while maintaining a calm and professional tone.
- Support Spanish speaking customers by reading writing and speaking in Spanish while ensuring that all information captured is translated accurately into operational systems.
- Escalate complex or high risk claim issues to senior claim specialists while providing complete background information to support quick and informed decisions.
- Monitor turnaround times and service level commitments while proactively following up on pending actions to avoid delays in claim resolution.
- Maintain strict adherence to data privacy and regulatory requirements for workers compensation claims while handling sensitive personal and medical information.
- Use claim management tools and customer service platforms efficiently while updating notes actions and outcomes with precise and concise descriptions.
- Collaborate with quality and training teams by sharing recurring customer issues and process gaps while contributing to continuous improvement of claim handling practices.
- Adhere to rotational shift schedules while managing workload and personal productivity in a fully remote work from home environment.
- Deliver a consistent customer experience that supports the organization purpose of protecting workers and enabling faster financial recovery after workplace injuries.
Qualifications
- Demonstrate professional experience in customer service of at least two years within an operations or contact center environment while handling high volume interactions.
- Show hands on exposure to workers compensation claims processes while understanding common claim lifecycle stages and standard documentation requirements.
- Apply strong verbal and written communication skills in Spanish and English while ensuring clarity empathy and cultural sensitivity in every interaction.
- Utilize basic analytical and problem solving skills while reviewing claim information identifying missing details and suggesting appropriate next actions.
- Exhibit familiarity with claim or case management systems and office productivity tools while adapting quickly to new digital platforms used by the organization.
- Display strong attention to detail while entering claim data updating records and verifying accuracy to reduce rework and operational risk.
- Maintain resilience in rotational shift schedules while effectively managing time focus and work life balance in a remote setup to sustain consistent performance.
Certifications Required
Any recognized certification in customer service or contact center operations such as Certified Customer Service Professional or equivalent would be beneficial.
关于高知特 (Cognizant)
高知特(Cognizant)（纳斯达克代码：CTSH）作为一家AI Builder和相关技术服务提供商，致力于通过打造全栈AI解决方案，帮助企业将人工智能投资转化为实际价值。公司凭借深厚的行业经验、流程优化和工程技术专长，将企业独特的业务场景融入科技系统，赋能组织释放人才潜能，推动切实成果，并帮助全球企业在瞬息万变的环境中保持领先。如需了解更多详情，敬请访问 cognizant.ai 或关注@cognizant。
补充雇佣信息
薪酬信息截至本职位发布之日为准。Cognizant 保留在适用法律允许的范围内随时修改该信息的权利。
申请人可能需要通过现场面试或视频会议的方式参加面试。此外，候选人在每次面试时可能需要出示其当前所在州或政府签发的有效身份证件。
Cognizant 是一家提供平等就业机会的雇主。在招聘过程中，您的申请和候选资格不会因种族、肤色、性别、宗教、信仰、性取向、性别认同、国籍、残疾、遗传信息、怀孕、退伍军人身份或任何其他受联邦、州或地方法律保护的特征而受到影响。
