Customer Service Representative – Revenue Recovery & Claims Resolution Specialist (Remote – Healthcare Reimbursement)

About brighthush

At brighthush, we are redefining the way healthcare providers and payers interact by delivering seamless, compliant, and customer‑centric revenue cycle solutions. Our mission is to empower patients, providers, and insurers with transparent, efficient, and technology‑driven processes that accelerate claim resolution and protect revenue streams. As a fast‑growing leader in the healthcare reimbursement space, brighthush blends deep industry expertise with innovative tools, creating a dynamic environment where every team member can make a measurable impact on the health of the financial ecosystem.

Why This Role Matters

The Customer Service Representative – Revenue Recovery & Claims Resolution Specialist is a pivotal position within brighthush’s Remote Operations Center. You will be the front‑line champion who safeguards held revenue by gathering critical documentation, interpreting payer medical policies, and collaborating with customers, payers, and internal stakeholders. Your work directly influences the speed and accuracy of claim settlements, improves cash flow for providers, and enhances the overall patient experience.

Key Responsibilities

• Revenue Recovery: Obtain, review, and validate all required documentation to support claim resolution for held revenue accounts.
• Stakeholder Communication: Serve as the primary point of contact for customers, payers, and internal teams, clarifying requirements, gathering missing information, and resolving outstanding issues.
• Policy Application: Apply in‑depth knowledge of payer medical policies, coverage criteria, and reimbursement guidelines to ensure claims are processed accurately and compliantly.
• Standard Operating Procedures (SOPs): Follow brighthush’s SOPs meticulously to maintain consistency, quality, and regulatory compliance across all workflows.
• Proactive Monitoring: Continuously monitor accounts for delays, missing documentation, or policy‑related barriers, taking swift corrective action to prevent revenue leakage.
• Trend Identification & Escalation: Detect recurring issues, gaps, or trends that affect revenue flow and either resolve them or recommend strategic solutions to leadership.
• Process Improvement Collaboration: Partner with teammates to streamline processes, share best practices, and drive operational efficiency.
• Documentation & Audit Readiness: Maintain precise records, notes, and system entries to support internal audits and external compliance reviews.
• Performance Metrics: Meet or exceed productivity, quality, and turnaround‑time targets as defined by departmental standards.
• Continuous Learning: Participate in ongoing training, policy updates, and improvement initiatives to stay current with evolving payer requirements and brighthush’s internal processes.

Essential Qualifications

• High School Diploma or GED (required).
• Minimum of 1 year of experience in held revenue, accounts receivable, medical billing, or related healthcare reimbursement functions.
• Demonstrated ability to interpret payer medical policies, coverage guidelines, and reimbursement rules.
• Proficiency with Microsoft Excel and Word, including data entry, documentation management, and basic reporting.
• Exceptional attention to detail with a proven track record of identifying discrepancies and resolving them efficiently.
• Strong written and verbal communication skills, capable of interacting professionally with customers, payers, and internal teams.
• Ability to manage multiple tasks simultaneously, prioritize workload, and meet productivity and quality expectations in a fast‑paced environment.
• Comfort with remote work and a self‑motivated mindset that thrives in a process‑driven setting.

Preferred Qualifications & Experience

• Experience within the healthcare industry, specifically in durable medical equipment (DME), insurance verification, or similar reimbursement domains.
• Familiarity with HIPAA regulations and the ability to maintain a compliant workspace.
• Previous exposure to revenue cycle management (RCM) software platforms or claim adjudication tools.
• Advanced Excel skills (pivot tables, VLOOKUP, macros) for data analysis and reporting.
• Certification or coursework related to medical billing, coding, or health information management.

Core Skills & Competencies

• Analytical Thinking: Ability to dissect complex claim scenarios, identify root causes, and propose actionable solutions.
• Customer‑Centric Mindset: Empathy and professionalism when dealing with patients and providers, ensuring a positive experience even in challenging situations.
• Technical Proficiency: Comfortable navigating web‑based portals, claim management systems, and internal databases.
• Time Management: Strong organizational skills to meet strict turnaround times while maintaining high quality.
• Collaboration: Team‑oriented attitude, willing to share knowledge and support peers in achieving collective goals.
• Adaptability: Ability to quickly adjust to evolving payer policies, regulatory changes, and internal process updates.

Work‑From‑Home Technical Requirements

To ensure optimal performance and compliance, candidates must have the following equipment and environment:

• High‑speed broadband internet (minimum 80 Mbps download, 10 Mbps upload) with a wired Ethernet connection.
• Network firewall and secure VPN access to brighthush data centers (latency
• Dual monitors (minimum 20‑inch each) for multitasking.
• Desktop or laptop with at least a 2.0 GHz processor, 8 GB RAM, and 1 GB free disk space.
• Wired keyboard and mouse (wireless devices not supported).
• USB headset (Bluetooth/AUX not supported) for clear, HIPAA‑compliant communication.
• Webcam for occasional video conferencing.
• Windows 11 operating system with automatic updates, active antivirus, and enabled Windows Firewall.
• Supported browsers: Google Chrome or Microsoft Edge (preferred).
• Dedicated, distraction‑free workspace with a door‑closed room, functional desk, and ergonomic chair.

Compensation, Perks & Benefits

While exact figures are tailored to experience and market benchmarks, brighthush offers a competitive salary package complemented by a comprehensive benefits suite designed to support your professional and personal well‑being:

• Health, dental, and vision insurance with multiple plan options.
• 401(k) retirement plan with company match.
• Paid time off (PTO), holidays, and sick leave.
• Remote‑work stipend for home office equipment and internet costs.
• Continuous learning budget for certifications, courses, and industry conferences.
• Employee assistance program (EAP) for mental health and wellness support.
• Recognition programs that celebrate high performers and innovative contributors.

Career Growth & Development at brighthush

brighthush is committed to nurturing talent from within. As a Customer Service Representative, you will have clear pathways to advance into senior analyst, team lead, or specialist roles in revenue cycle management, compliance, or operations strategy. Our robust training curriculum, mentorship programs, and cross‑functional project opportunities empower you to broaden your skill set and accelerate your career trajectory.

Our Culture & Values

We pride ourselves on a culture that blends professionalism with compassion. At brighthush, you will experience:

• Integrity: Every interaction is guided by honesty, transparency, and ethical standards.
• Collaboration: Open communication channels and a supportive team environment encourage knowledge sharing.
• Innovation: We continuously explore new technologies and process improvements to stay ahead of industry changes.
• Customer Focus: Our people are dedicated to delivering exceptional service that improves patient outcomes and provider satisfaction.
• Work‑Life Balance: Flexible scheduling and remote work options help you maintain a healthy personal and professional life.

How to Apply

If you are ready to join a forward‑thinking organization where your expertise directly contributes to the financial health of healthcare providers, we want to hear from you. Click the link below to submit your application through brighthush’s secure career portal.

Apply to This Position at brighthush

Closing Statement

At brighthush, every claim you help resolve, every document you validate, and every conversation you lead brings us one step closer to a more efficient, patient‑centric healthcare system. Join us today, and become a catalyst for positive change in the revenue cycle landscape.