Job Summary
This role supports a global insurance client by handling workers compensation claims and providing empathetic customer service in a hybrid work model. The specialist reviews claim details updates records and communicates with claimants and internal teams in Spanish and English. The role focuses on accurate claim handling timely resolution and a positive service experience.
Responsibilities
- Handle end to end workers compensation claims by gathering details validating coverage and documenting every interaction to ensure accurate and timely case resolution
- Provide empathetic customer service by actively listening to injured workers employers and medical providers and offering clear explanations that reduce stress and confusion
- Review claim documents medical reports and wage information to determine compensability and benefits while maintaining compliance with company policies and applicable regulations
- Coordinate with internal teams such as claims examiners nurses and legal specialists to support thorough and fair claim decisions that align with organizational standards
- Update claim management systems with detailed notes payment information and status changes to maintain accurate records and enable effective reporting
- Communicate in Spanish and English with customers and stakeholders by phone email and chat to ensure clear understanding of claim status and next steps
- Resolve customer inquiries related to claim status payment schedules documentation requirements and policy coverage in a timely and professional manner
- Identify potential issues such as missing documents conflicting statements or unusual claim patterns and escalate them to appropriate specialists to mitigate risk
- Follow standard operating procedures quality guidelines and service level agreements to deliver consistent and reliable claims service across all assigned cases
- Support continuous improvement initiatives by sharing insights on recurring customer issues system gaps or process inefficiencies that may impact service quality
- Collaborate in a hybrid work environment by managing time effectively balancing remote and office tasks and ensuring availability during rotational shifts
- Adhere to confidentiality standards data privacy rules and ethical guidelines to protect sensitive customer and company information throughout the claims lifecycle
- Contribute to the company mission by helping injured workers receive timely benefits thereby supporting financial stability and wellbeing in the broader community
Qualifications
- Demonstrate proven experience in customer service roles handling complex inquiries and resolving concerns with patience professionalism and clear communication
- Apply working knowledge of workers compensation claims processes including intake investigation benefit calculation and ongoing claim maintenance
- Utilize strong Spanish reading writing and speaking skills to support customers and stakeholders who prefer or require communication in Spanish
- Exhibit familiarity with insurance or claims administration environments including basic understanding of regulatory expectations and documentation standards
- Use productivity tools and claim management systems with accuracy and attention to detail to minimize errors and rework
- Show strong problem solving skills by analyzing available information identifying appropriate next steps and following through to closure for each claim
- Display flexibility to work rotational shifts in a hybrid model while maintaining consistent service quality and meeting performance metrics
Certifications Required
Preferred certifications include certification in customer service or insurance claims such as AIC or similar recognized claims qualification
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。
