Customer Care Representative I – Virtual Member Support Specialist for Health Benefits & Services at brighthush

Welcome to brighthush – Transforming Health Care for Millions

At brighthush, we are on a mission to simplify health care, improve lives, and strengthen communities across the nation. As a Fortune 25 leader in the health‑care industry, we combine cutting‑edge technology with compassionate service to deliver seamless experiences for our members. Our culture is built on purpose, collaboration, and continuous growth, empowering every associate to make a tangible impact every day.

Why This Role Matters

Our members rely on knowledgeable, empathetic professionals to navigate the complexities of insurance benefits, provider networks, eligibility, and claims. As a Customer Care Representative I, you will be the trusted voice that guides members through their health‑care journey, ensuring they receive accurate information, timely resolutions, and a positive experience that reflects brighthush’s commitment to excellence.

Position Overview

This is a primarily virtual, full‑time role that offers flexibility while still providing essential in‑person training and onboarding. You will work within a structured schedule, with shifts ranging from 9:30 AM to 8:00 PM Eastern Time (adjusted for your local time zone). The position is designed for individuals who thrive in a fast‑paced, high‑pressure environment and who are eager to develop a career in health‑care customer service.

Key Responsibilities

• Member Interaction: Respond to inbound and outbound calls, emails, texts, and electronic queue messages from internal and external customers regarding insurance benefits, provider contracts, eligibility, and claims.
• Problem Analysis & Resolution: Analyze member inquiries, identify root causes, and deliver clear, accurate solutions or appropriate escalations.
• Documentation: Accurately capture inquiry details, actions taken, and outcomes in brighthush’s CRM system to support tracking, reporting, and continuous improvement.
• Collaboration: Coordinate with cross‑functional teams—including claims, provider relations, and IT—to ensure member requests are resolved efficiently and effectively.
• Data Retrieval & Reporting: Operate PC/image stations to extract, verify, and update member information; generate reports as needed for operational insights.
• Follow‑Up Communication: Conduct timely follow‑up calls and emails for routine inquiries, ensuring members feel heard and supported.
• Multi‑Tasking: Manage simultaneous communication channels while maintaining detailed notes and delivering consistent, high‑quality service.
• Continuous Learning: Complete required basic training modules, pass pre‑employment assessments, and stay current on brighthush policies, product offerings, and industry regulations.
• Additional Duties: Perform other tasks as assigned, contributing to team goals and operational excellence.

Essential Qualifications

• High school diploma or equivalent (GED) required.
• Previous experience in an automated customer service environment, such as a call center or virtual support desk.
• Strong verbal and written communication skills, with the ability to convey complex information in a clear, empathetic manner.
• Demonstrated ability to multitask, prioritize, and remain focused during extended periods of sitting and high call volume.
• Basic proficiency with digital tools, CRM platforms, and Microsoft Office Suite.
• Ability to pass the required pre‑employment test battery and complete all onboarding training.
• Commitment to maintaining confidentiality and adhering to HIPAA and other health‑care privacy regulations.

Preferred Skills, Capabilities, and Experiences

• Prior call‑center experience, especially in health‑care or insurance settings.
• Familiarity with health‑care terminology, provider networks, eligibility verification, and claims processes.
• Experience working in a URAC‑accredited environment, demonstrating strong oral, written, and interpersonal communication, problem‑solving, facilitation, and analytical abilities.
• Proficiency with multiple communication channels (phone, email, chat, fax) and the ability to quickly adapt to new digital platforms.
• Demonstrated empathy, patience, and persistence when handling member concerns.

Core Skills & Competencies for Success

• Customer‑Centric Mindset: A genuine desire to help members and improve their health‑care experience.
• Critical Thinking: Ability to assess situations, identify gaps, and propose effective solutions.
• Attention to Detail: Precise documentation and data entry to ensure accuracy and compliance.
• Team Collaboration: Comfortable working with peers, specialists, and managers to resolve complex issues.
• Adaptability: Thrive in a dynamic environment with evolving processes and technology.
• Time Management: Efficiently balance multiple tasks while meeting service level agreements (SLAs).

Work Environment & Culture at brighthush

brighthush embraces a hybrid workforce strategy that blends virtual flexibility with occasional on‑site collaboration. While the majority of your work will be performed from a home office, you will attend scheduled in‑person training sessions and may be asked to work from a brighthush location once per week or as business needs dictate.

Our culture is built on four pillars:

• Purpose‑Driven Impact: Every associate contributes to improving health outcomes for millions of members.
• Inclusive Collaboration: Diverse perspectives are celebrated, and every voice is heard.
• Continuous Learning: We provide robust training, mentorship, and tuition‑reimbursement programs.
• Well‑Being First: Comprehensive health, wellness, and mental‑health resources support a balanced life.

Compensation, Perks, & Benefits

brighthush offers a market‑competitive total rewards package designed to attract and retain top talent:

• Base salary commensurate with experience, plus performance‑based incentive bonuses.
• Comprehensive medical, dental, vision, and prescription drug coverage.
• Short‑ and long‑term disability, life insurance, and accidental death & dismemberment coverage.
• Paid Time Off (PTO), paid holidays, and flexible scheduling options.
• 401(k) plan with company match and a stock purchase program.
• Wellness programs, including virtual fitness classes, mental‑health resources, and employee assistance programs.
• Professional development funds, tuition reimbursement, and internal mobility pathways.
• Employee recognition programs that celebrate outstanding service and innovation.

Career Growth & Development Opportunities

Starting as a Customer Care Representative I opens multiple pathways within brighthush:

• Specialist Tracks: Advance to senior representative, claims specialist, or provider relations analyst.
• Leadership Pathways: Move into team lead, supervisor, or manager roles overseeing larger service units.
• Cross‑Functional Mobility: Leverage your experience to transition into training, quality assurance, or operations analysis.
• Continuous Learning: Access to e‑learning platforms, certifications, and mentorship programs to deepen industry expertise.

Commitment to Diversity, Equity, & Inclusion

brighthush is an Equal Employment Opportunity employer. We celebrate diversity and are committed to creating an inclusive environment where every associate feels valued and empowered. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic.

Health & Safety Requirements

In alignment with public‑health guidelines, all new hires in member‑facing roles must be vaccinated against COVID‑19 and influenza, unless a legally acceptable exemption is provided. brighthush adheres to all federal, state, and local regulations regarding workplace safety and employee health.

How to Apply

If you are ready to launch a rewarding career helping members navigate their health‑care journey, we invite you to submit your application through our online portal. Please ensure your resume highlights relevant customer‑service experience, any health‑care exposure, and your commitment to delivering exceptional member care.

Join brighthush and Make a Difference Every Day

At brighthush, your work directly influences the health and well‑being of millions. You will be part of a supportive, forward‑thinking team that values your growth, celebrates your successes, and equips you with the tools to excel. Take the next step in your professional journey—apply today and become a vital voice in the future of health care.