Dedicated Government Programs Customer Service Representative – Medicare & Medicaid Support Specialist – Remote Michigan Role with brighthush

About brighthush and the Opportunity

brighthush is a trailblazer in the health benefits arena, delivering comprehensive, innovative solutions that empower individuals and families across Michigan and beyond. With a proud legacy of community partnership, cutting‑edge technology, and an unwavering commitment to customer excellence, brighthush has become synonymous with trust, integrity, and impact. Our mission is simple: to improve the lives of the people we serve by ensuring they receive the benefits they deserve, when they need them.

We are expanding our Government Programs team and are looking for a passionate, detail‑oriented Customer Service Representative to join our remote Michigan workforce or the Farmington Hills office. As a frontline advocate for Medicare and Medicaid beneficiaries, you will play a pivotal role in safeguarding the financial security and quality of care for our members.

Why This Role Matters

In the Government Programs division, every call you handle is an opportunity to make a tangible difference. Your expertise in Medicare and Medicaid will help maintain the integrity of our claims processing, foster trust with government partners, and uphold brighthush’s reputation for exceptional service. This position is essential to our commitment to delivering accurate, timely, and compassionate support to those who rely on us.

Key Responsibilities

Customer Interaction

• Respond to inbound inquiries from Medicare and Medicaid beneficiaries, providing clear, accurate information about benefits, eligibility, and claim status.
• Deliver a consistently positive experience, demonstrating empathy, patience, and professionalism in every interaction.

Documentation & Compliance

• Accurately record all call details in our customer relationship management (CRM) system, ensuring compliance with brighthush policies and internal quality standards.
• Maintain meticulous records of member interactions, claim updates, and resolution steps to support audit readiness.

Claims Processing

• Review, verify, and process claims in a timely manner, coordinating with internal teams to resolve discrepancies and expedite reimbursements.
• Utilize brighthush’s claims adjudication tools to ensure accuracy and adherence to Medicare/Medicaid regulations.

Problem Solving

• Identify and resolve issues related to coverage, billing, and service delivery, escalating complex cases to senior specialists when necessary.
• Apply analytical thinking to troubleshoot and resolve member concerns efficiently.

Continuous Improvement

• Participate in training sessions, share feedback on process enhancements, and contribute to the development of best practices for government program support.
• Stay current on policy changes, regulatory updates, and new technologies that impact Medicare and Medicaid services.

Team Collaboration

• Work closely with cross‑functional teams—including underwriting, compliance, and technology—to ensure seamless service delivery.
• Contribute to team goals, share insights, and support colleagues in achieving shared objectives.

Essential Qualifications

• High school diploma or equivalent; associate’s or bachelor’s degree in a related field is a plus.
• Minimum of 2 years of customer service experience, preferably in a call center environment handling Medicare/Medicaid or other government‑related programs.
• Proficient in Windows operating systems and experienced with CRM platforms (e.g., Salesforce, Zendesk).
• Strong verbal and written communication skills in English, with the ability to convey complex information clearly and compassionately.
• Demonstrated ability to work independently in a remote setting, managing time effectively and maintaining high productivity.
• Must reside in Michigan and be available to work 8‑hour shifts between 7:55 am and 11 pm, with flexibility for occasional weekend or holiday coverage.
• Successful completion of customer service assessments and background checks.

Preferred Qualifications

• Experience with Medicare Advantage or Medicaid Managed Care plans.
• Knowledge of Medicare and Medicaid governing regulations, including HIPAA compliance.
• Previous exposure to claims adjudication or billing systems.
• Multilingual abilities (Spanish, French, or other languages) are a plus.
• Strong analytical skills and attention to detail, with a proven track record of maintaining data integrity.

Key Skills & Competencies

• Customer‑Centric Mindset: Passion for helping others and a desire to continuously improve member experiences.
• Problem‑Solving: Ability to analyze issues, identify root causes, and implement effective solutions.
• Adaptability: Comfortable navigating changing priorities, new technologies, and evolving regulatory requirements.
• Team Player: Collaborative spirit, open to feedback, and eager to support colleagues.
• Tech Savvy: Quick learner of new software tools and comfortable troubleshooting basic technical issues.
• Time Management: Skilled at prioritizing tasks, meeting deadlines, and maintaining high call volume without sacrificing quality.

Career Growth & Learning Opportunities

At brighthush, we believe that investing in our people is the key to sustained success. As a Government Programs Customer Service Representative, you will benefit from:

• Structured Onboarding: Comprehensive training covering Medicare/Medicaid policies, claims processing, and customer service excellence.
• Mentorship: Guidance from seasoned professionals in the Government Programs division.
• Cross‑Departmental Projects: Opportunities to broaden your skill set and gain exposure to new facets of the business.
• Clear Career Pathways: Advancement opportunities to roles such as Claims Analyst, Government Programs Specialist, or Team Lead, based on performance.
• Performance Reviews: Regular feedback and personalized development plans to help you reach your professional goals.

Work Environment & Culture at brighthush

brighthush fosters a culture of inclusion, innovation, and integrity. Our remote workforce enjoys the flexibility to balance personal and professional commitments while remaining connected through:

• Weekly virtual team huddles and monthly all‑hands meetings.
• Collaborative digital workspaces (Teams, SharePoint) that enable seamless communication.
• Access to a virtual library of learning resources, webinars, and industry certifications.
• Regular virtual social events, wellness challenges, and community outreach initiatives.
• A supportive leadership team that values transparency, accountability, and employee well‑being.

Compensation, Perks, and Benefits

While specific salary ranges are competitive and commensurate with experience, brighthush offers a comprehensive benefits package designed to support your health, financial security, and personal growth:

• Competitive Base Salary: Reflective of industry standards and your experience level.
• Performance Bonuses: Opportunities to earn additional compensation based on individual and team performance metrics.
• Generous Paid Time Off (PTO): Accrued days, sick leave, and personal days to recharge.
• Health & Wellness: Comprehensive medical, dental, and vision plans, including telehealth services.
• Retirement Plan: 401(k) with company match to help you build long‑term financial stability.
• Tuition Reimbursement: Up to $5,000 annually for courses related to your role or career development.
• Employee Assistance Program (EAP): Confidential counseling and support services.
• Wellness Initiatives: Gym membership discounts, mindfulness apps, and wellness stipends.
• Flexible Work Arrangements: Remote work with optional on‑site days at our Farmington Hills office.

How to Apply

If you are ready to bring your customer service expertise to a mission‑driven organization that values innovation, collaboration, and personal growth, we encourage you to apply today. Join brighthush and help us shape the future of government program benefits for Michigan’s residents.