Job Summary
This role supports the SPE Ins Claims demand by handling workers compensation claims for a global insurance client while working from home in a rotational shift model. The specialist delivers high quality customer service in Spanish and English ensuring accurate claim intake validation and resolution for injured workers and employers. The position focuses on timely processing empathetic communication and compliance with internal policies and regulatory standards.
Responsibilities
- Handle end to end workers compensation claim intake by gathering detailed information from policyholders and injured workers to ensure accurate creation of claim records in the system
- Review claim documents such as incident descriptions medical notes and wage details to validate coverage and determine the appropriate next steps for each claim
- Communicate with customers in Spanish and English through calls and written channels to provide clear updates on claim status and required documentation
- Coordinate with internal claims adjusters medical providers and employer contacts to support timely investigation and resolution of workers compensation claims
- Maintain high standards of customer service by demonstrating empathy patience and clarity while managing sensitive conversations with injured workers and employers
- Ensure compliance with company policies and relevant regulatory guidelines by following established procedures and documenting all claim activities in a structured manner
- Utilize claim management tools and customer service platforms to log interactions track tasks and monitor progress against agreed service levels
- Analyze claim trends and recurring issues in assigned workload to identify opportunities for process improvements that enhance customer experience and operational efficiency
- Collaborate with cross functional teams such as underwriting billing and operations to resolve discrepancies and ensure consistency of data across systems
- Manage work in a rotational shift environment by planning tasks efficiently and adapting to varying workloads while meeting productivity and quality expectations
- Support continuous improvement initiatives by sharing practical insights from daily claim handling and proposing enhancements to scripts templates and workflows
- Adhere to confidentiality standards by safeguarding personal and medical information for all parties involved in the workers compensation claim process
- Assist in training and knowledge sharing within the team by documenting best practices and frequently asked questions derived from real customer interactions
Qualifications
- Meet the minimum experience requirement of two to three years in customer service with a strong record of handling complex or sensitive customer interactions in a structured environment
- Demonstrate practical experience in workers compensation claims including understanding of claim lifecycle from first notice of loss to closure and associated documentation needs
- Exhibit fluent Spanish reading writing and speaking skills along with strong English communication to support bilingual claim handling and customer interactions
- Show proficiency in using claim or case management systems customer relationship tools and office productivity applications to maintain accurate and timely records
- Display strong analytical and problem solving skills with the ability to interpret claim information identify missing data and take appropriate follow up actions
- Apply sound judgment in prioritizing cases based on urgency severity and regulatory timelines to ensure timely responses and resolution for claim stakeholders
- Embrace a work from home environment by maintaining a professional workspace reliable connectivity and self discipline to meet all shift and performance expectations
Certifications Required
Preferred certification in customer service or claims handling such as AIC Associate in Claims or equivalent industry training
Acerca de Cognizant
Cognizant (Nasdaq: CTSH) es un creador de soluciones de IA y proveedor de servicios tecnológicos que conecta la inversión en IA con el valor empresarial mediante el desarrollo de soluciones de IA full‑stack para sus clientes. Su profundo conocimiento de la industria, junto con su experiencia en procesos e ingeniería, permite incorporar el contexto único de cada organización en sistemas tecnológicos que amplifican el potencial humano, generan resultados tangibles y mantienen a las empresas a la vanguardia en un entorno en constante cambio. Más información en cognizant.ai o @cognizant.
Información adicional sobre el empleo
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