Job Summary
Join our dynamic team as a Specialist in Insurance Claims where you will leverage your expertise in MS Excel to streamline processes and enhance efficiency. With a hybrid work model and rotational shifts you will play a crucial role in supporting underwriting functions ensuring accuracy and compliance in claims processing. Your contributions will drive operational excellence and positively impact our clients and the community.
Responsibilities
- Handle end to end processing of insurance claims within agreed timelines ensuring that coverage validation liability assessment and payment decisions are accurate and compliant with internal policies and external regulations.
- Manage customer interactions across phone email or digital channels with a calm and empathetic approach clearly explaining claim status required documentation and next steps to achieve positive service outcomes.
- Review claim documents policy schedules loss descriptions and supporting evidence to identify missing information inconsistencies or potential red flags that may impact claim decisions or require further investigation.
- Coordinate with internal stakeholders such as underwriting policy servicing and quality teams to clarify complex policy terms endorsements and exclusions that influence claim eligibility and settlement amounts.
- Apply structured problem solving to claim scenarios by comparing facts with policy coverage evaluating alternative resolution options and selecting the most appropriate settlement approach to protect customer interests and organizational guidelines.
- Use claim administration tools and customer service platforms to log interactions update claim notes track service level metrics and maintain data integrity for accurate reporting and audit readiness.
- Follow standard operating procedures escalation matrices and approval thresholds to route complex or high value claims to appropriate experts while maintaining accountability for timely updates to customers.
- Ensure strict compliance with information security confidentiality requirements and data privacy standards when handling personal and financial data associated with insurance claims and customer records.
- Monitor personal performance metrics such as average handling time first contact resolution claim accuracy and customer satisfaction indicators and take proactive actions to close gaps against defined targets.
Qualifications
- Possess 2-4 years of hands on experience in insurance domain operations, claims processing or related fields with consistent exposure to customer service activities in a structured delivery environment.
- Demonstrate flexibility to work in a hybrid model and rotational shifts balancing office collaboration days with remote work while maintaining reliable connectivity and productivity.
- Demonstrate strong customer service skills by handling inquiries grievances and complex claim situations with patience clear articulation and solution oriented communication.
- Show ability to quickly learn and navigate multiple claim administration systems and customer communication tools while maintaining high accuracy in data entry and documentation.
- Display strong analytical thinking by reviewing claim evidence identifying patterns and interpreting policy wording in a manner that supports fair and defensible claim outcomes.
- Maintain high attention to detail and quality orientation so that every claim decision communication and record update aligns with established process controls and audit expectations.
- Possess effective written and verbal communication skills in business English to interact with global customers and internal teams ensuring clarity politeness and professionalism in every interaction.
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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