Customer service representative

Job Summary

This hybrid day shift specialist role focuses on handling workers compensation insurance claims while delivering high quality customer service in Spanish and English. The specialist manages end to end claim processing supports injured workers and employer clients and ensures accurate documentation and resolution in line with regulatory and company standards for fair and timely claim outcomes.

Responsibilities

• Manage workers compensation claims from initial intake through closure by capturing detailed incident information and ensuring accurate claim setup in internal systems for timely and compliant processing.
• Handle inbound and outbound customer interactions in Spanish and English by actively listening to injured workers and employer contacts and providing clear information on claim status benefits and next steps.
• Assess claim documentation such as injury reports medical notes and wage statements by verifying completeness and consistency to support fair benefit determination according to company policies and regulatory requirements.
• Coordinate with medical providers employers and internal teams by gathering relevant information and resolving discrepancies to maintain a coherent and up to date claim file that supports efficient decisions.
• Explain workers compensation benefits coverage limitations and procedural steps by using accessible language so claimants and employers clearly understand their rights obligations and available support.
• Monitor claim progress against service level targets by tracking tasks follow ups and outstanding documents to minimize delays and improve overall claim resolution timelines.
• Identify potential claim issues such as incomplete information inconsistent narratives or possible fraud indicators by escalating complex cases to senior claims specialists for further review and guidance.
• Document each customer interaction and decision point comprehensively in claim systems by following standardized formats to ensure accurate records and support audits and quality reviews.
• Collaborate with customer service colleagues and claims peers in a hybrid work model by sharing insights and best practices that enhance claim handling consistency and customer satisfaction.
• Apply problem solving techniques to address claimant and employer concerns by proposing practical solutions that balance customer needs with compliance and cost effectiveness for the organization.
• Adhere to regulatory and company standards for workers compensation claims by staying current with policy updates and procedural changes to reduce errors and safeguard organizational integrity.
• Utilize digital tools and internal applications efficiently by navigating claim screens and knowledge resources to quickly locate information and deliver responsive service during each customer contact.
• Contribute to continuous improvement by providing feedback on recurring customer pain points and process gaps that can inform enhancements to workflows guidance and training materials.

Qualifications

• Demonstrate proven experience of two to three years in customer service environments handling complex inquiries and resolving issues with empathy accuracy and timely follow through.
• Show solid hands on exposure to workers compensation claims operations including intake investigation documentation and benefit explanation across multiple case types and scenarios.
• Communicate fluently in Spanish and English for reading writing and speaking by adapting tone and clarity to diverse customer backgrounds while maintaining professionalism and respect.
• Apply strong analytical skills when reviewing claim information by identifying missing elements inconsistencies and potential risks that could affect entitlement or payment decisions.
• Use established case management or claims systems confidently by entering updating and retrieving data with high attention to detail to limit processing errors and rework.
• Demonstrate knowledge of basic regulatory concepts relevant to workers compensation including common timelines documentation expectations and claimant protections.
• Exhibit resilience and emotional maturity when managing conversations with individuals experiencing workplace injuries or financial stress by remaining calm patient and solutions focused.

Certifications Required

Preferred certification in claims handling or insurance such as Workers Compensation Claims Professional or equivalent customer service training

À savoir avant de postuler

• Autorisation de travail: Cognizant ne prendra en considération que les candidats à ce poste qui sont légalement autorisés à travailler au Canada sans avoir besoin d'un parrainage de l'employeur, aujourd'hui ou à l'avenir.
• Mesures d’adaptation: Si vous avez un handicap qui nécessite des mesures d’adaptation raisonnable pour effectuer une recherche d’emploi ou poser une candidature, veuillez envoyer un courriel à [email protected] avec votre demande et vos coordonnées.
• L’IA dans notre processus de recrutement: Nous utilisons des outils d'intelligence artificielle (IA) pour trier et évaluer les candidatures efficacement. Notre équipe examine ensuite les candidatures et décide qui passe à l’étape suivante.
• Poste à pourvoir: Sauf indication contraire, ce poste est actuellement vacant et nous cherchons à le pourvoir.
• Exigences linguistiques: Nous demandons à tous les candidats de posséder une connaissance de base de l’anglais afin de faciliter les communications internes. Pour les postes au Québec, la capacité à communiquer efficacement en anglais est requise car vous fournirez des services à et collaborerez avec des parties prenantes anglophones situées hors de la province.
• Inclusion: Cognizant est un employeur souscrivant au principe de l’égalité d’accès à l’emploi. Votre candidature et votre dossier ne seront pas examinés en fonction de la race, de la couleur, du sexe, de la religion, des croyances, de l'orientation sexuelle, de l'identité de genre, de l'origine nationale, du handicap, des renseignements génétiques, de la grossesse, du statut d'ancien combattant ou de toute autre caractéristique protégée par les lois fédérales, provinciales ou locales.

À propos de Cognizant
Cognizant (NASDAQ: CTSH) est un AI Builder et une entreprise de services numériques (ESN) élaborant des solutions complètes d’IA maximisant les investissements pour des résultats concrets. Sa profonde expertise des métiers, des processus et des technologies lui permet d’intégrer dans les systèmes technologiques le contexte unique de chaque organisation de l’ingénierie à la production à l’échelle. Son objectif: améliorer l’efficacité des équipes, créer de la valeur et permettre aux grandes entreprises de rester performantes dans un monde qui évolue rapidement. Pour en savoir plus: cognizant.ai ou @cognizant.