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.
Sobre a Cognizant
Cognizant (NASDAQ: CTSH) é uma construtora de IA e fornecedora de serviços de tecnologia, criando a ponte entre o investimento em IA e o valor para as empresas por meio do desenvolvimento de soluções de IA completas para nossos clientes. Nossa profunda experiência em setores, processos e engenharia nos permite incorporar o contexto único de cada organização em sistemas tecnológicos que potencializam a capacidade humana, geram resultados tangíveis e mantêm empresas globais à frente em um mundo em rápida transformação. Saiba mais em cognizant.ai ou @cognizant.
A Cognizant é uma empregadora que investe em equidade. Sua candidatura não será pautada em raça, cor, gênero, sexualidade, credo, origem, deficiência, gravidez ou qualquer outra característica protegida pelas leis brasileiras.
Informações adicionais de emprego
Os candidatos podem ser obrigados a comparecer a entrevistas presenciais ou por videoconferência. Além disso, os candidatos podem ser obrigados a apresentar seu documento de identificação emitido pelo estado ou governo atual durante cada entrevista.
Embora nosso sistema permita a candidatura em todos os idiomas, o(s) idioma(s) e o(s) nível(is) de proficiência exigidos para o trabalho variam. No entanto, é necessário um nível básico de inglês para fins de comunicação em toda a empresa.
A Cognizant é uma empregadora que investe em equidade. Sua candidatura não será pautada em raça, cor, gênero, sexualidade, credo, origem, deficiência, gravidez ou qualquer outra característica protegida pelas leis brasileiras.
Se você tem uma deficiência que requer adaptações razoáveis para procurar uma vaga de emprego ou enviar uma candidatura, envie um e-mail para [email protected] com sua solicitação e informações de contato.