Customer Service Advocate – Claims & Benefits Specialist – Remote, Full‑Time – brighthush

About brighthush

brighthush is a leading not‑for‑profit health‑insurance provider dedicated to delivering compassionate, innovative care to members across the United States. With a legacy of community‑first values and a forward‑thinking approach to wellness, brighthush empowers its workforce to make a real difference in people’s lives. Our mission is simple: to provide reliable, affordable coverage while fostering a culture of collaboration, continuous learning, and personal growth.

Position Overview

As a Customer Service Advocate – Claims & Benefits Specialist, you will serve as the frontline champion for our members, ensuring they receive timely, accurate information and support throughout their insurance journey. This remote, full‑time role offers the flexibility to work from any of the 27 eligible states while being part of a dynamic, high‑performing team that values innovation, empathy, and excellence.

Key Responsibilities

• Resolve Customer Inquiries: Handle a high volume of member calls, emails, and chat requests, providing clear, concise, and accurate responses regarding coverage, benefits, and claims status.
• Educate Members: Deliver educational sessions and resources that help members understand their plans, eligibility, and the claims process, thereby enhancing member satisfaction and engagement.
• Support Complex Claims: Investigate and resolve intricate claims issues, collaborating with internal stakeholders and external partners to expedite resolution and maintain compliance with regulatory standards.
• Maintain Accurate Records: Log all interactions in the Facets system, ensuring data integrity, audit readiness, and adherence to privacy regulations.
• Continuous Improvement: Identify trends, propose process enhancements, and participate in cross‑functional projects aimed at improving member experience and operational efficiency.
• Team Collaboration: Attend virtual huddles, training sessions, and knowledge‑sharing meetings to stay current on product updates, policy changes, and best practices.

Essential Qualifications

• Education: High school diploma or GED equivalent. A bachelor’s degree in Business, Healthcare Administration, or a related field is a plus.
• Experience: Minimum of 3 years in a customer‑service or claims environment, preferably within the health‑insurance or related industry.
• Technical Proficiency: Demonstrated ability to navigate enterprise systems such as Facets; familiarity with IPP (Integrated Provider Portal) is highly desirable.
• Communication Skills: Exceptional verbal and written communication skills in English, with the ability to convey complex information in a member‑friendly manner.
• Problem‑Solving: Strong analytical mindset, capable of troubleshooting issues, identifying root causes, and implementing effective solutions.
• Compliance Awareness: Knowledge of HIPAA, ACA, and other relevant regulatory frameworks governing member data and claims processing.

Preferred Qualifications

• Facets Expertise: Advanced proficiency in Facets, including claims entry, status tracking, and reporting.
• IPP Experience: Hands‑on experience with the Integrated Provider Portal, enabling seamless coordination with healthcare providers.
• Multilingual Abilities: Fluency in Spanish or another language is an asset, allowing you to serve a broader member base.
• Leadership Potential: Demonstrated ability to mentor junior staff or lead small project teams.

Skills & Competencies

• Customer‑centric mindset with a passion for service excellence.
• Strong organizational skills and meticulous attention to detail.
• Adaptability to changing priorities and fast‑paced environments.
• Team player who thrives in virtual collaboration settings.
• Proactive learner eager to stay updated on industry trends and product innovations.

Career Growth & Learning Opportunities

At brighthush, we believe in investing in our people. As a Customer Service Advocate, you will have access to a comprehensive learning portal featuring courses on claims processing, regulatory compliance, and advanced customer‑experience strategies. Our internal career ladder offers clear pathways to roles such as Senior Claims Analyst, Team Lead, or even Managerial positions in Operations or Member Services. Mentorship programs, quarterly skill‑building workshops, and cross‑departmental shadowing opportunities ensure you continuously grow professionally and personally.

Work Environment & Company Culture

brighthush fosters a culture of inclusion, transparency, and innovation. Even though this role is remote, you will be fully integrated into our virtual community through weekly team meetings, monthly town halls, and informal virtual coffee breaks. We celebrate diversity, encourage open dialogue, and empower employees to bring their authentic selves to work. Our flexible scheduling model supports work‑life balance, allowing you to manage your responsibilities while staying connected with colleagues across the country.

Compensation & Benefits

Salary Range: $41,600 – $66,561 per year, commensurate with experience and qualifications.

Benefits Package:

• 401(k) plan with company matching to help you build a secure financial future.
• Generous paid time off (PTO) policy, including vacation, sick leave, and personal days.
• Health, dental, and vision insurance plans with competitive premiums.
• Wellness stipend for gym memberships, mental‑health resources, and wellness apps.
• Employee assistance program (EAP) for confidential counseling and support.
• Professional development stipend and tuition reimbursement for relevant certifications.

Eligibility & Work Location

This remote position is open to candidates residing in any of the following states: North Carolina, Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, or Wyoming. Applicants must be legally authorized to work in the United States and possess a reliable internet connection and a suitable home‑office setup.

How to Apply

If you are passionate about delivering exceptional member service, thrive in a collaborative remote environment, and are ready to grow your career with a purpose‑driven organization, we encourage you to apply today. Submit your resume and a brief cover letter outlining your relevant experience and why you would be an excellent fit for brighthush. We look forward to welcoming you to our team and working together to make a lasting impact on the lives of our members.