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.
Über Cognizant
Cognizant (NASDAQ: CTSH) i ist ein Technologiedienstleister und Entwickler von KI-Lösungen. Wir schlagen die Brücke zwischen KI-Investitionen und echtem unternehmerischem Mehrwert, indem wir ganzheitliche Full-Stack-KI-Lösungen für unsere Kunden entwickeln. Mit unserer fundierten Branchen-, Prozess- und Engineering-Expertise integrieren wir die spezifischen Anforderungen von Unternehmen passgenau in Technologiesysteme. So entfalten wir das menschliche Potenzial, erzielen greifbare Ergebnisse und sichern globalen Unternehmen in einer sich rasant wandelnden Welt den entscheidenden Vorsprung. Erfahren Sie mehr unter cognizant.ai oder @cognizant.
Zusätzliche Informationen zur Beschäftigung
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