Job Summary
This role supports workers compensation insurance claims by delivering high quality customer service in a remote work from home environment. The specialist manages claim inquiries in Spanish and English documents interactions accurately and coordinates with internal teams to resolve issues. The position follows rotational shifts with no travel requirement.
Responsibilities
- Handle end to end customer inquiries for workers compensation claims by actively listening to callers needs and providing clear resolutions that enhance customer satisfaction levels
- Manage multiple claim related cases by documenting every interaction in detail and updating claim systems to maintain accurate and timely records
- Coordinate with internal claims adjusters medical providers and employer representatives to gather required information and move claims toward timely decisions
- Respond to claim status questions in Spanish and English by explaining complex coverage and process details in simple language that improves claimant understanding
- Escalate complex or disputed claim issues to appropriate senior claims staff while providing complete background information that supports faster resolution
- Adhere to all regulatory requirements and internal claims procedures by following established guidelines that protect data privacy and operational compliance
- Monitor claim service levels by tracking response times and pending items and taking proactive action to reduce delays and improve cycle times
- Provide empathetic support to injured workers and employers by acknowledging their concerns and offering practical guidance that contributes to a positive service experience
- Utilize customer service tools call scripts and knowledge bases by applying them consistently to deliver accurate information and reduce handling errors
- Participate in quality reviews and feedback sessions by using insights from coaching to refine communication skills and improve call handling effectiveness
- Contribute to continuous improvement initiatives by sharing observations about recurring customer pain points and suggesting practical process enhancements
- Support rotational shift operations by maintaining schedule reliability and collaborating with peers to ensure consistent service coverage across all assigned hours
- Use digital collaboration tools to work effectively in a remote setting by maintaining clear written communication habits that support strong teamwork outcomes
Qualifications
- Possess a minimum of two years of hands on experience in customer service with direct exposure to managing complex customer interactions in a structured operations environment
- Demonstrate proven experience in workers compensation claims handling or claims support by working with injured workers employers and claims professionals in an insurance setting
- Apply strong Spanish language capability in reading writing and speaking by handling bilingual calls and written communications without reliance on translation support
- Exhibit proficiency in using claim management or customer relationship systems by entering data accurately and navigating multiple applications during live customer interactions
- Display solid understanding of basic insurance and claims terminology related to workers compensation by using this knowledge to explain processes clearly to customers
- Show capability to work independently in a work from home model by maintaining focus meeting productivity targets and following security protocols
- Illustrate strong problem solving and de escalation skills by calmly addressing frustrated customers and guiding conversations toward constructive outcomes
- Maintain high standards of professionalism and ethical conduct by respecting confidentiality and treating every claimant and employer with fairness and empathy
Certifications Required
Any recognized customer service or call center certification such as Certified Customer Service Professional or equivalent will be an added advantage
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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