Experienced Customer Service Representative II – Healthcare Claims & Member Support Specialist – Remote, Full‑Time, 40‑Hour Week

About brighthush

At brighthush, we’re on a mission to make healthcare simpler, more transparent, and more human. Every day, our dedicated team works to transform the way people experience health coverage, ensuring that members, providers, and partners receive the support they need to thrive. We’re proud to be recognized as one of the best workplaces in the industry, thanks to a culture that values collaboration, continuous learning, and purpose‑driven impact.

As a global leader in health benefits, brighthush blends cutting‑edge technology with a deep commitment to people. From AI‑powered virtual assistants to comprehensive wellness programs, we empower our employees to innovate, grow, and lead with empathy. If you’re looking for a role where your voice matters, your skills are challenged, and your career can truly flourish, brighthush is the place for you.

Why Join brighthush?

• Impactful Work – Every interaction you handle directly improves a member’s experience and supports the broader mission of better healthcare.
• Remote Flexibility – Work from home full‑time with a predictable 8‑hour shift that fits your lifestyle.
• Comprehensive Benefits – From medical, dental, and vision coverage to a generous 401(k) match, pension plan, and wellness incentives, we care for your health, finances, and well‑being.
• Career Growth – 70% of promotions in our Operations division come from Customer Service roles. You’ll have clear pathways to advanced positions and cross‑functional opportunities.
• Learning & Development – 12 weeks of paid virtual training, tuition assistance for undergraduate and graduate courses, and access to industry‑leading tools like our AI‑powered virtual agent, ALICE.
• Recognition & Rewards – Participate in the RISE program, earn floating holidays, and celebrate milestones with team‑wide recognition.
• Inclusive Culture – We celebrate diversity, champion equity, and provide a supportive environment where every employee can bring their authentic self to work.

Key Responsibilities

As a Customer Service Representative II (CSR II) at brighthush, you will be the frontline champion for our members and providers. Your day‑to‑day tasks will include:

• Handle inbound and outbound phone calls, emails, and chat inquiries with a focus on first‑call resolution.
• Conduct thorough research to provide accurate claims status updates and resolve routine questions.
• Escalate complex issues to the appropriate departments while maintaining clear documentation of all interactions.
• Process and route paperwork, ensuring timely completion and compliance with regulatory standards.
• Maintain confidentiality of Personal Protected Information (PPI) and adhere to HIPAA guidelines.
• Meet or exceed performance metrics, including call volume, resolution time, and customer satisfaction scores.
• Participate in continuous improvement initiatives, providing feedback on processes and tools.
• Adapt communication style to diverse audiences, from individual members to healthcare providers and vendors.
• Support team collaboration by sharing best practices and contributing to knowledge bases.

Essential Qualifications

• High School Diploma or GED (required).
• Minimum of 2 years of customer service experience in a high‑volume environment (e.g., call center, insurance, benefits).
• Proficiency in Microsoft Office Suite or equivalent platforms, with the ability to navigate multiple screens simultaneously.
• Strong conflict‑resolution skills, demonstrating empathy and respect in every interaction.
• Excellent verbal and written communication abilities.
• Ability to adapt to shifting priorities and work a variety of shifts if required.
• Experience with healthcare or insurance claims processing is highly desirable.
• Comfort with technology, including AI‑powered virtual agents and screen‑recording tools.

Preferred Qualifications

• College coursework (2 years) or 3+ years of experience in customer service.
• Background in healthcare, insurance, benefits, or claims processing.
• Experience in a call center with high‑volume inbound/outbound calls.
• Familiarity with regulatory compliance, PPI handling, and HIPAA best practices.
• Previous exposure to ALICE or similar AI‑driven support platforms.

Skills & Competencies

• Customer‑Centric Mindset – Passion for delivering exceptional service and a genuine desire to help others.
• Analytical Thinking – Ability to quickly assess information, identify root causes, and propose effective solutions.
• Attention to Detail – Precision in data entry, documentation, and compliance adherence.
• Time Management – Efficiently juggle multiple tasks while meeting performance targets.
• Team Collaboration – Willingness to share knowledge, support peers, and contribute to a positive work environment.
• Adaptability – Thrive in a fast‑changing environment and embrace new technologies and processes.

Career Growth & Learning Opportunities

At brighthush, we believe that your career should evolve with you. As a CSR II, you’ll gain:

• In‑depth knowledge of the healthcare ecosystem, including provider relationships and claims workflows.
• Regulatory and compliance expertise, especially around PPI and HIPAA.
• Hands‑on experience with AI tools like ALICE, preparing you for future tech‑driven roles.
• Clear progression pathways to senior CSR roles, operations leadership, or cross‑functional positions such as claims analyst, provider relations specialist, or compliance officer.
• Access to ongoing training, mentorship programs, and tuition assistance for both undergraduate and graduate studies.

Work Environment & Culture

Our remote work model is designed for flexibility and productivity. You’ll enjoy:

• A predictable Monday‑Friday schedule with 8‑hour shifts between 5 a.m. and 8 p.m. Pacific Time.
• 12 weeks of paid virtual training to set you up for success.
• A one‑time pre‑tax home office stipend of $500 (after taxes) to create a comfortable workspace.
• Regular virtual team meetings, knowledge sharing sessions, and community events.
• Opportunities to collaborate with colleagues across multiple states, including Eastern Washington, Idaho, Oregon, Montana, Utah, Minnesota, Wisconsin, Tennessee, North Carolina, South Carolina, Georgia, Florida, Texas, and Arizona.

Compensation & Benefits

While the exact salary will be determined based on location, market conditions, and experience, the national range for this role is $38,500.00 – $57,800.00. We aim to target the midpoint of this range and are open to discussing compensation during the interview process.

Beyond base pay, brighthush offers:

• Medical, vision, and dental coverage with low employee premiums.
• Life and disability insurance.
• Employer‑matched 401(k) and a pension plan vested after 3 years.
• Generous paid time off, including 8 paid days and 2 floating holidays.
• Tuition assistance for undergraduate and graduate courses.
• Wellness incentives, counseling services, and mindfulness programs.
• Employee recognition through the RISE program and milestone celebrations.
• Optional commuter perks and flexible work arrangements for hybrid employees.

Equal Opportunity Employer

brighthush is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees, regardless of race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender identity, sexual orientation, or any other protected characteristic.

Ready to Make a Difference?

If you’re passionate about customer service, eager to learn, and ready to contribute to a mission that improves lives, we want to hear from you. Join brighthush as a Customer Service Representative II and become part of a team that values innovation, collaboration, and purpose.

Click the link below to apply and start your journey with brighthush today.