Experienced Customer Service Agent II – Claims & Call Center Operations – Remote, Full‑Time – Join brighthush

About brighthush

brighthush is a trailblazing technology partner that empowers health insurance carriers with AI‑driven operational infrastructure. By automating claims processing, streamlining provider interactions, and delivering real‑time analytics, we give our clients a sustainable competitive advantage in an increasingly complex marketplace. Our solutions are built on a foundation of data science, cloud scalability, and a relentless focus on customer experience. As we continue to grow, we are looking for passionate, detail‑oriented professionals who want to shape the future of healthcare technology.

Role Overview

As a Customer Service Agent II at brighthush, you will be the frontline advocate for our UST customers. Reporting directly to the Customer Service Manager, you will manage inbound and outbound calls, resolve claims inquiries, and serve as the critical liaison between the claims department and healthcare providers. Your work will support a 24‑hour call center that operates from 8 a.m. to 9 p.m. EST, ensuring that every customer interaction reflects the highest standards of professionalism and efficiency.

Key Responsibilities

• Handle inbound calls from UST customers, providing timely, accurate assistance and ensuring a positive customer experience.
• Initiate outbound call requests to follow up on pending claims or to gather additional information from providers.
• Document every interaction in our ticketing and tracking systems, maintaining meticulous records for audit and quality purposes.
• Research and verify customer claims using primary payor systems, ensuring compliance with plan benefits and regulatory requirements.
• Act as a liaison between the claims department and healthcare providers, translating complex policy details into clear, actionable information.
• Respond to customer inquiries via phone, email, or chat, delivering data and solutions within required timeframes.
• Maintain a comprehensive understanding of covered plan benefits, Medicare/Medicare Advantage plans, and other relevant healthcare regulations.
• Collaborate with cross‑functional teams (claims, IT, compliance) to resolve escalated issues and improve service processes.
• Adhere to quality standards, performance metrics, and call center best practices.
• Participate in ongoing training and development initiatives to stay current on industry trends and product updates.
• Perform additional duties as assigned to support the overall success of the customer service team.

Essential Qualifications

• High school diploma or equivalent (college coursework or a bachelor’s degree is a plus).
• 2–3 years of experience in healthcare claims operations or a call center environment.
• Strong verbal and written communication skills, with the ability to convey complex information clearly.
• Exceptional attention to detail and problem‑solving abilities.
• Proficiency with Microsoft Office applications, especially Word and Excel.
• Comfortable working flexible shifts, including evenings and weekends, to cover the 8 a.m.–9 p.m. EST window.
• Basic understanding of Medicare and Medicare Advantage plans (preferred).
• Experience with ticketing or CRM systems (e.g., Salesforce, Zendesk).

Preferred Qualifications

• Prior experience working with health insurance carriers or in a health technology company.
• Knowledge of health insurance regulations such as HIPAA, ACA, and state‑specific mandates.
• Familiarity with claims adjudication workflows and electronic health record (EHR) systems.
• Demonstrated ability to work independently while maintaining strong collaboration with remote teams.
• Experience in a remote or hybrid work environment, with a reliable home office setup.

Skills & Competencies

• Customer‑Centric Mindset: Passion for delivering exceptional service and turning challenges into opportunities.
• Analytical Thinking: Ability to interpret data, identify trends, and propose actionable solutions.
• Adaptability: Comfortable navigating changing priorities and evolving technology platforms.
• Team Collaboration: Strong interpersonal skills to work effectively with cross‑functional teams.
• Time Management: Proven track record of meeting deadlines and managing multiple tasks simultaneously.
• Technical Proficiency: Comfortable using call center software, ticketing systems, and basic troubleshooting tools.

Career Growth & Development

At brighthush, we believe that your growth is our success. As a Customer Service Agent II, you will have access to a robust learning ecosystem:

• Structured onboarding program with mentorship from senior agents.
• Regular training modules covering product updates, compliance, and soft‑skill development.
• Clear career ladder: from Agent II to Senior Agent, Team Lead, and beyond into operations or product management.
• Opportunities to participate in cross‑departmental projects, expanding your skill set and visibility.
• Annual performance reviews that align compensation, bonuses, and advancement.

Work Environment & Culture

brighthush fosters a culture of innovation, collaboration, and inclusivity. Our remote‑first approach means you can work from anywhere in the United States while staying connected through:

• Weekly virtual team huddles and monthly all‑hands meetings.
• Open‑door communication channels with leadership.
• Access to a digital resource hub with training videos, FAQs, and knowledge bases.
• Employee wellness initiatives, including virtual fitness classes and mental health support.
• A commitment to diversity, equity, and inclusion, ensuring every voice is heard and valued.

Compensation & Benefits

While the base hourly rate for this role ranges from $18 to $21, the total compensation package at brighthush is designed to reward performance, expertise, and dedication:

• Competitive base salary with performance‑based bonuses.
• Health, dental, and vision insurance plans for employees and eligible dependents.
• 401(k) retirement plan with company matching.
• Paid time off (vacation, sick leave, and holidays).
• Flexible work schedule and remote work options.
• Professional development stipend and tuition reimbursement.
• Employee assistance program and wellness resources.
• Regular team‑building events and virtual social gatherings.

How to Apply

If you are ready to bring your customer service expertise to a dynamic, technology‑driven environment, we encourage you to apply today. Submit your resume and a brief cover letter outlining why you’re the ideal fit for the Customer Service Agent II role at brighthush. We look forward to exploring how your skills can help us continue to transform the healthcare industry.

Join brighthush – Where Innovation Meets Service

At brighthush, every call is an opportunity to make a difference. We’re building the future of health insurance technology, and we need dedicated professionals who thrive on solving complex problems and delivering world‑class service. If you’re passionate about healthcare, technology, and customer experience, this is the place for you. Apply now and become part of a team that’s redefining the industry.