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.
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。