Customer Service Representative – Workers Compensation Claims (Spanish)

About the role

We are seeking an experienced Customer Service Representative to manage workers compensation insurance claims, providing high‑quality support to claimants in both English and Spanish. The position operates in a hybrid environment with rotational shifts, combining remote and on‑site work.

Key responsibilities

• Manage end‑to‑end workers compensation claims, gathering information from claimants, employers and medical providers.
• Handle complex claim inquiries via customer service channels, delivering clear guidance and improving satisfaction.
• Coordinate with internal claims teams, adjusters and operations staff to streamline case handling and reduce delays.
• Document all claim interactions, assessments and decisions in the claims system with high attention to detail.
• Communicate fluently in Spanish to support claimants who prefer the language, reducing communication barriers.
• Respond empathetically to injured workers, employers and medical partners, explaining claim status and next steps.
• Escalate high‑risk or unusual claims to senior specialists following defined protocols.
• Analyze claim data, medical reports and employment records to identify patterns and recommend appropriate actions.
• Collaborate with legal, compliance and medical review teams to resolve discrepancies and ensure regulatory compliance.
• Utilize customer service best practices to decrease repeat contacts and improve first‑contact resolution.
• Monitor personal workload, prioritize tasks and meet service‑level expectations in a hybrid setting.

Required profile

• Proven experience handling workers compensation claims.
• Fluent reading, writing and speaking Spanish.
• Strong communication and empathy when dealing with claimants and stakeholders.
• Ability to work rotational shifts in a hybrid environment.
• Excellent attention to detail and documentation accuracy.

Required skills