Customer Experience Consultant, Worksite

Customer Experience Consultant, Worksite Supplemental Health Operations,

Fulltime/hybrid, Boston or Springfield

The Opportunity

MassMutual’s Worksite team is adding Customer Experience Consultant to support our growth with our supplemental products. The CCT Servicing Consultant is a dynamic, cross-functional role responsible for delivering exceptional customer service and operational support across Billing, Claims (Accident & Critical Illness), Policy Servicing, Indexing, and Employee Benefits, and leading QA initiatives ensuring system accuracy across multiple platforms, partners with cross functional teams to deliver customer focused initiatives improving overall service quality and client satisfaction.

The Team

The Worksite Insurance business is growing as we aim to reach middle class workers in support of MassMutual’s vision to provide financial well-being to all Americans. Worksite has achieved success in recent years distributing our Group Voluntary and Executive products through our multi-channel distribution relationships. To further this success, we must continue to evolve our strategy to reach more benefits producers and customers, while providing them an enhanced self-service, digital experience to allow us to aggressively grow top line sales. Worksite, which provides protection benefits such as life, disability, critical illness and accident insurance through employers, complements MassMutual’s retirement plans business with the goal of enhancing the financial wellness of Americans through their employers.

The Impact:

This position requires experience in supplemental health insurance, process documentation, and operational readiness, with the ability to thrive in a highly matrixed environment and drive end-to-end execution.

Key Responsibilities responsible for but not limited to:

• Conduct target audits on invoices for supplemental health insurance policies; applied premium, outstanding and suspense payments, and billing discrepancies

• Review and evaluate claims for Accident and Critical Illness products, ensuring compliance with policy terms, regulatory requirements, and state guidelines.

• Review and communicate process policy changes, updates, quotes, cancellations, and respond to client inquiries regarding policy details, coverage, and claims 

• Handle escalated inbound/outbound calls and emails regarding claims, billing, policy servicing, and portal issues. Provide exceptional customer service and troubleshoot customer inquiries

• Document use cases, test scenarios, procedures, and decisions needed for operational readiness. Execute on testing and support User Acceptance Testing (UAT) for claims and billing processes

• Navigate process and customer journey maps, translating insights into operational readiness and improvements.

• Develop, review, and maintain Standard Operating Procedures (SOPs) to ensure efficient and up-to-date processes.

• Curate and manage a central repository of playbooks, best practices, and resources to support day-to-day tasks.

• Work effectively across functional and organizational boundaries, collaborating with Business Analysts (BA), Product Owners (PO), Project Managers (PM), and other stakeholders.

• Take ownership of processes from billing to payment, including analysis of flows and requirements, and drive execution

• Support integration of claims with external providers and manage add-on services.

• Review current customer service setup (call tree, talking points), analyze flows, and recommend improvements.

• Leverage experience with policy administration platforms, and Electronic Data Interchange (EDI).

• Support and assist with Third Party Administrator (TPA) claims training, and review/co-sign TPA claims and billing refunds for accuracy and compliance.

• Assist in monitoring CSR performance to ensure service standards are met.

The Minimum Qualifications

• 5+ years of Insurance Industry experience and/or supplemental or group health insurance operations, claims backend, billing, and policy servicing.

The Ideal Qualifications

• Experience in customer service, claims adjudication, billing, and policy administration.

• Exposure to technical platforms (EIS, EDI) and process improvement initiatives.

• Experience supporting TPA operations and training.

• Experience in documenting use cases, test cases, procedures, and decisions; ability to analyze and translate process maps into actionable steps.

• Ability to navigate and interpret process and customer journey maps.

• Proven ability to work in a matrix environment, manage execution, and collaborate across functions (BA, PO, PM, etc.).

• Comfortable taking on E2E responsibility and driving results.

• Experience working in Agile environments.

• Exposure to quoting, product setup, and enrollment processes in addition to servicing.

• Experience with EIS or similar platforms; familiarity with EDI.

• Experience working with TPAs and understanding their processes.

• Strong communication and interpersonal skills; ability to review and optimize customer service flows.

• Experience in monitoring and improving team performance.

• Ability to develop SOPs and conduct UAT for claims and billing.

• Proficiency in MS Excel and reporting tools.

• Understanding of HIPAA, ERISA, and state regulations.

• High level of accuracy and attention to detail.

• Strong critical thinking and decision-making skills.

• Ability to work under pressure, meet deadlines, and adapt to changing priorities.

What to Expect as Part of MassMutual and the Team

• Regular meetings with the Worksite Supplemental Health Operations Team.

• Focused one-on-one meetings with your manager

• Networking opportunities including access to Asian, Hispanic/Latinx, African American, women, LGBTQ, veteran and disability-focused Business Resource Groups

• Access to learning content on Degreed and other informational platforms

• Your ethics and integrity will be valued by a company with a strong and stable ethical business with industry leading pay and benefits

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MassMutual is an equal employment opportunity employer. We welcome all persons to apply.

If you need an accommodation to complete the application process, please contact us and share the specifics of the assistance you need.