Job Summary
This role supports an international organization by handling workers compensation insurance claims for customers through remote work in a day shift schedule. The specialist provides empathetic and accurate customer service in Spanish and English ensuring timely resolution of claims and clear communication. The position focuses on efficient claim handling regulatory adherence and a positive customer experience in a fully virtual environment.
Responsibilities
- Handle end to end workers compensation claims by gathering information recording details accurately and ensuring timely processing to support fair and consistent outcomes for all parties involved.
- Manage high volume customer service interactions for workers compensation claims through phone and digital channels maintaining a calm and professional tone to resolve inquiries efficiently.
- Provide clear explanations of workers compensation coverage claim status and next steps in both Spanish and English helping customers and claimants understand their rights and responsibilities.
- Document every customer contact claim update and decision in the claim management system with strong attention to detail ensuring that all records are complete and audit ready.
- Coordinate with internal teams such as medical review investigations and payments to obtain required information and move each workers compensation claim toward timely resolution.
- Review medical reports incident descriptions and employer statements to validate claim information and identify any missing data needed to support accurate decisions.
- Apply company policies and jurisdictional guidelines consistently when evaluating workers compensation claims supporting fair outcomes and reducing claim handling risks.
- Communicate claim decisions and actions to claimants employers and internal partners in a respectful and empathetic manner anticipating questions and addressing concerns proactively.
- Support quality and compliance objectives by following standard operating procedures participating in internal audits and correcting any identified data or process gaps promptly.
- Use customer feedback and claim trends to suggest improvements in processes and customer communication helping the organization deliver more efficient and compassionate claims service.
- Manage daily work in a remote environment by organizing tasks meeting productivity targets and using collaboration tools to stay connected with the wider claims team.
- Protect sensitive personal and medical information by rigorously following data privacy expectations and secure handling practices in all customer and claim interactions.
- Contribute to the company mission by helping injured workers receive timely benefits supporting employers with clear information and ultimately strengthening trust in the workers compensation system.
Qualifications
- Demonstrate professional experience in customer service roles for at least two years with consistent performance in handling complex or sensitive customer interactions.
- Show proven exposure to workers compensation claims with clear understanding of claim intake investigation benefit calculation and closure activities.
- Use fluent Spanish reading writing and speaking skills along with strong English communication to interact effectively with multilingual claimants and employers.
- Apply strong listening skills empathy and problem solving abilities to manage distressed customers and guide them calmly through the claims journey.
- Operate comfortably in a work from home setup by maintaining reliable connectivity following virtual work protocols and managing time to meet day shift expectations.
- Utilize claim management or customer service tools with confidence entering data accurately and navigating multiple applications during live customer conversations.
- Display familiarity with basic insurance concepts especially within workers compensation including wage replacement medical benefits and return to work coordination.
- Adapt quickly to updated policies new procedures and changes in claim handling guidelines showing flexibility and commitment to continuous learning.
Certifications Required
Preferred certifications include Customer Service certification or Insurance claims related certification such as AIC or similar.
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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