Job Summary
This hybrid role supports workers compensation claims operations by delivering consistent customer service in Spanish and English for injured workers employers and partners. The specialist reviews claim information documents interactions and follows defined processes to ensure timely claim handling in rotational shifts without travel while maintaining compliance and quality in a global MNC environment.
Responsibilities
- Handle inbound and outbound customer interactions related to workers compensation claims in Spanish and English to ensure timely and accurate resolution of inquiries and requests.
- Document claim related conversations and updates in the claims system with clear summaries to maintain accurate records and support efficient case handling.
- Review claim files for completeness and correctness to confirm that required information such as incident details and claimant data is captured and ready for adjudication.
- Coordinate with internal operations teams to clarify claim related questions and to support smooth progression of claims through established workflows.
- Apply approved guidelines and procedures to routine claims service activities to help ensure consistent decisions and adherence to company and regulatory expectations.
- Respond to status requests from claimants employers and partners with clear and empathetic communication to support understanding of claim progress.
- Escalate complex or sensitive claim service issues to senior team members as needed to reduce risk and improve customer outcomes.
- Perform data entry and validation for new and existing workers compensation claims to minimize errors and support accurate reporting.
- Follow rotational shift schedules and adhere to attendance expectations to provide continuous service coverage across time periods.
- Support process improvement efforts by identifying recurring service issues and sharing observations with the supervisor to enhance customer experience.
- Adhere to confidentiality and data protection standards when handling sensitive claim and personal information to protect all stakeholders.
- Monitor personal performance metrics such as service levels quality scores and productivity to contribute to team targets and organizational goals.
- Engage in training and upskilling activities focused on workers compensation claim practices customer service techniques and language proficiency to maintain and improve job performance.
Qualifications
- Possess foundational experience in customer service environments with exposure to call handling email support or similar client facing activities that demonstrate strong communication and problem solving abilities.
- Demonstrate working knowledge of workers compensation claims concepts including claim intake documentation tracking and basic benefit understanding in a structured operations setting.
- Communicate fluently in Spanish and English in both spoken and written forms to support diverse customers and stakeholders with clarity and cultural sensitivity.
- Show ability to follow standardized procedures guidelines and scripts while accurately capturing details and adapting to different customer needs within those boundaries.
- Exhibit strong attention to detail when entering and reviewing claim information to reduce rework and support compliance and audit readiness.
- Display resilience and professionalism while working in rotational shifts handling repetitive tasks and managing occasional high volume periods in a hybrid environment.
- Use basic office productivity tools and claims or customer service systems to navigate records update information and retrieve case details efficiently.
Certifications Required
Relevant certification in customer service or contact center operations such as a recognized customer service professional credential
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。