Work from Home Appeals and Grievance Specialists. The Appeals and Grievance Specialist plays a key role in helping members navigate and understand their benefits related to Appeals, External Medical Review, and the Fair Hearing process. Acts as the first point of contact for members, providing support and information through both verbal and written communication throughout the resolution journey. Compensation Highlights: - Base Pay: Up to $22 an hour - Pay Frequency: Weekly  Schedule Highlights: - Training Schedule: 2 weeks, Monday-Friday, 8:00 AM - 5:00 PM CST - Production Schedule: Monday-Friday, 8:00 AM - 5:00 PM CST, no weekends!  

Senior Medical Claims Resolution Specialist 1. Foster and maintain provider relationship to facilitate current and future negotiations by * Performing claim research and analysis to provide support for desired savings. * Generating agreement by communicating with provider by written and verbal communication throughout the negotiation process; and * Partnering with internal and external clients, including Account Managers, Customer Relations, Provider Services, and direct client contacts as applicable. 2. Meet and maintain established departmental performance metrics. Manage high volume of claims in a queue; keep current with all claim actions and meet client deadlines for working and closing claims. 3. Initiate provider telephone calls with respect to proposals, overcome objections and apply effective telephone negotiation skills to reach successful resolution on negotiated claims. 4. Address counteroffers received and present proposal for resolution while adhering to client guidelines and department goals. 5. Identify and seek opportunities to achieve savings with previously challenging/unsuccessful providers. 6. Participate in projects and initiatives, as necessary. 7. Collaborate, coordinate, and communicate across disciplines and departments.

💎Customer Service Associate Must be willing to work ANY 8- hour shift within our operations, 8am-8pm Eastern Time, Monday- Friday, based on business need (NO WEEKENDS) Salary: $45,000- plus ability to earn 5% bonus 6 Weeks Paid Virtual Training Upcoming Training Class: January 12, 2026- February 20,2026 Wired high speed internet required, (No Wi-Fi) ❕The Minimum Qualifications 1+ year of customer service experience (or Undergrad Degree in lieu of experience) High School Diploma (or GED) https://careers.massmutual.com/job/springfield/customer-service-associate/724/87629748304 https://careers.massmutual.com/job/springfield/customer-service-associate/724/87629748304

Claims Specialist II, Workers Compensation USA As a Claims Specialist, you’ll investigate and handle medical and/or loss-of-time workers compensation claims from multiple states to determine compensability, entitled benefits, average weekly wage and benefit rate according to applicable state workers’ compensation statute. We’ll count on you to promote and provide exemplary customer service. Key to success will be your ability to establish timely and appropriate case reserves aligned with Best Practices and manage claims to appropriate resolution. You’ll also communicate frequently with customers, injured workers and medical providers.