Job Summary
This role supports the SPE Ins Claims demand by handling workers compensation claims for a global insurance client while working from home in a rotational shift model. The specialist delivers high quality customer service in Spanish and English ensuring accurate claim intake validation and resolution for injured workers and employers. The position focuses on timely processing empathetic communication and compliance with internal policies and regulatory standards.
Responsibilities
- Handle end to end workers compensation claim intake by gathering detailed information from policyholders and injured workers to ensure accurate creation of claim records in the system
- Review claim documents such as incident descriptions medical notes and wage details to validate coverage and determine the appropriate next steps for each claim
- Communicate with customers in Spanish and English through calls and written channels to provide clear updates on claim status and required documentation
- Coordinate with internal claims adjusters medical providers and employer contacts to support timely investigation and resolution of workers compensation claims
- Maintain high standards of customer service by demonstrating empathy patience and clarity while managing sensitive conversations with injured workers and employers
- Ensure compliance with company policies and relevant regulatory guidelines by following established procedures and documenting all claim activities in a structured manner
- Utilize claim management tools and customer service platforms to log interactions track tasks and monitor progress against agreed service levels
- Analyze claim trends and recurring issues in assigned workload to identify opportunities for process improvements that enhance customer experience and operational efficiency
- Collaborate with cross functional teams such as underwriting billing and operations to resolve discrepancies and ensure consistency of data across systems
- Manage work in a rotational shift environment by planning tasks efficiently and adapting to varying workloads while meeting productivity and quality expectations
- Support continuous improvement initiatives by sharing practical insights from daily claim handling and proposing enhancements to scripts templates and workflows
- Adhere to confidentiality standards by safeguarding personal and medical information for all parties involved in the workers compensation claim process
- Assist in training and knowledge sharing within the team by documenting best practices and frequently asked questions derived from real customer interactions
Qualifications
- Meet the minimum experience requirement of two to three years in customer service with a strong record of handling complex or sensitive customer interactions in a structured environment
- Demonstrate practical experience in workers compensation claims including understanding of claim lifecycle from first notice of loss to closure and associated documentation needs
- Exhibit fluent Spanish reading writing and speaking skills along with strong English communication to support bilingual claim handling and customer interactions
- Show proficiency in using claim or case management systems customer relationship tools and office productivity applications to maintain accurate and timely records
- Display strong analytical and problem solving skills with the ability to interpret claim information identify missing data and take appropriate follow up actions
- Apply sound judgment in prioritizing cases based on urgency severity and regulatory timelines to ensure timely responses and resolution for claim stakeholders
- Embrace a work from home environment by maintaining a professional workspace reliable connectivity and self discipline to meet all shift and performance expectations
Certifications Required
Preferred certification in customer service or claims handling such as AIC Associate in Claims or equivalent industry training
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。
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