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SME-Ins Claims

00069339091



Job Summary

This hybrid role offers an opportunity for an experienced subject matter expert in insurance claims to support customer service operations within a multinational organization. The role focuses on delivering accurate and timely claims support enhancing customer experience and ensuring adherence to insurance domain standards while working in rotational shifts within a collaborative and diverse environment.


Responsibilities

  • Manage complex insurance claims by validating information coordinating with internal stakeholders and ensuring accurate resolution that aligns with organizational standards and customer expectations.
  • Provide specialized support for customer inquiries related to claim status policy coverage and documentation requirements to deliver a consistent and empathetic service experience.
  • Analyze claim trends and service patterns to identify recurring issues propose process enhancements and support continuous improvement initiatives within the claims function.
  • Collaborate with operations teams to align claim handling practices with regulatory guidelines internal policies and domain best practices for insurance claims management.
  • Document claim decisions and customer interactions in a clear and structured manner to maintain transparent records that support audits reviews and internal reporting.
  • Coordinate with quality and training teams to share insights from daily claims handling enabling targeted coaching and updated reference materials for customer service teams.
  • Support rotational shift operations by adapting to different time zones and workload variations while maintaining consistent service quality and adherence to service level expectations.
  • Assist in stabilizing new process changes by providing feedback on workflow updates identifying potential operational risks and suggesting corrective actions.
  • Guide junior team members on claims procedures and customer service etiquette by sharing domain knowledge and practical case scenarios that support on the job learning.
  • Contribute to customer satisfaction initiatives by identifying opportunities to simplify communication reduce claim handling time and improve first contact resolution.
  • Engage with technology and support teams to report system issues suggest enhancements for claims tools and help test new functionalities that improve daily operations.
  • Ensure compliance with data privacy and confidentiality standards in all customer and claim related interactions to safeguard sensitive information and uphold company obligations.
  • Participate in hybrid work arrangements by effectively managing onsite and remote responsibilities while maintaining collaboration with cross functional teams.

  • Qualifications

  • Possess five to eight years of hands on experience in insurance claims or related domain with strong exposure to customer service operations in a high volume environment.
  • Demonstrate solid understanding of insurance concepts and claim lifecycle including intake assessment investigation settlement and closure within an organized workflow.
  • Apply advanced customer service skills such as active listening clear communication and issue resolution to manage challenging customer interactions.
  • Leverage experience in property and casualty insurance where available to handle specialized claim scenarios and support domain specific queries from internal teams.
  • Utilize analytical skills to interpret claim data identify anomalies and support root cause analysis for process related issues.
  • Adapt to rotational shifts by managing time effectively and maintaining work performance and reliability across varying schedules.
  • Use collaboration and communication tools efficiently in a hybrid model to stay aligned with team objectives and operational updates.
  • Exhibit familiarity with standard office productivity tools and claims management systems to perform daily tasks efficiently and accurately.
  • Show commitment to continuous learning by keeping knowledge current on insurance regulations market practices and internal process updates.

  • Certifications Required

    Preferred certifications include insurance domain certifications such as AINS or equivalent customer service certification relevant to claims management.


    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。

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