Job Summary
This role focuses on delivering high quality customer service in a work from home model for an international organization that manages workers compensation claims. The specialist handles complex insurance claim inquiries supports Spanish speaking customers and ensures fair and timely resolution.
Responsibilities
- Handle end to end workers compensation claim inquiries by responding to customers in a timely and empathetic manner while maintaining high service quality standards.
- Manage inbound and outbound interactions through multiple communication channels while ensuring every customer contact is accurately documented and resolved.
- Coordinate with internal claims teams to gather necessary information on open cases while ensuring that all claim details are up to date and compliant with process guidelines.
- Analyze claim information such as incident narratives medical documents and wage details while identifying gaps or discrepancies that require further clarification.
- Provide clear and understandable explanations of policy coverage claim status and next steps to workers employers and other stakeholders while maintaining a calm and professional tone.
- Support Spanish speaking customers by reading writing and speaking in Spanish while ensuring that all information captured is translated accurately into operational systems.
- Escalate complex or high risk claim issues to senior claim specialists while providing complete background information to support quick and informed decisions.
- Monitor turnaround times and service level commitments while proactively following up on pending actions to avoid delays in claim resolution.
- Maintain strict adherence to data privacy and regulatory requirements for workers compensation claims while handling sensitive personal and medical information.
- Use claim management tools and customer service platforms efficiently while updating notes actions and outcomes with precise and concise descriptions.
- Collaborate with quality and training teams by sharing recurring customer issues and process gaps while contributing to continuous improvement of claim handling practices.
- Adhere to rotational shift schedules while managing workload and personal productivity in a fully remote work from home environment.
- Deliver a consistent customer experience that supports the organization purpose of protecting workers and enabling faster financial recovery after workplace injuries.
Qualifications
- Demonstrate professional experience in customer service of at least two years within an operations or contact center environment while handling high volume interactions.
- Show hands on exposure to workers compensation claims processes while understanding common claim lifecycle stages and standard documentation requirements.
- Apply strong verbal and written communication skills in Spanish and English while ensuring clarity empathy and cultural sensitivity in every interaction.
- Utilize basic analytical and problem solving skills while reviewing claim information identifying missing details and suggesting appropriate next actions.
- Exhibit familiarity with claim or case management systems and office productivity tools while adapting quickly to new digital platforms used by the organization.
- Display strong attention to detail while entering claim data updating records and verifying accuracy to reduce rework and operational risk.
- Maintain resilience in rotational shift schedules while effectively managing time focus and work life balance in a remote setup to sustain consistent performance.
Certifications Required
Any recognized certification in customer service or contact center operations such as Certified Customer Service Professional or equivalent would be beneficial.
私たちについて：
コグニザント（NASDAQ: CTSH）は、AI builderおよびテクノロジーサービスプロバイダとして、AI投資を企業価値へとつなげるフルスタックのAIソリューションを提供しています。業界、業務プロセス、エンジニアリングに関する深い専門性を強みに、各企業固有のコンテキストをテクノロジーシステムに組み込み、人の力を最大限に引き出すとともに、具体的な成果の創出と、急速に変化する世界におけるグローバル企業の競争力維持を支援します。詳しくは、当社ウェブサイト www.cognizant.com をご覧ください。
雇用に関する追加情報
本募集に記載されている報酬情報は、掲載日時点で正確なものです。Cognizantは、適用される法令に従い、いつでも本情報を変更する権利を留保します。
応募者は、対面またはビデオ会議による面接への参加を求められる場合があります。また、各面接の際に、現在有効な州政府または政府発行の身分証明書の提示を求められる場合があります。
Cognizantは機会均等雇用主です。応募および選考において、人種、肌の色、性別、宗教、信条、性的指向、性自認、国籍、障がい、遺伝情報、妊娠、退役軍人の地位、その他連邦法・州法・地方自治体の法律により保護されるいかなる特性に基づく差別も行いません。
