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.
コグニザントについて
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ーとして、お客様にフルスタックのAIソリューションを構築することで、AI投資と企業価値を結ぶ架け橋となっています。業界、ビジネスプロセス、エンジニアリングに関する当社の深い専門知識を活かし、組織固有のビジネス環境をテクノロジー・システムに組み込みます。これにより、人間の可能性を最大限に引き出し、確かな成果を実現するとともに、急速に変化する世界においてグローバル企業が常に一歩先を行くための支援を行っています。 詳細については、cognizant.ai 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。