Experienced Employee Benefits Customer Service Representative – Claims Resolution & Client Support Specialist

About brighthush

brighthush is a trailblazer in the insurance brokerage and consulting arena, renowned for delivering innovative, client‑centric solutions across the United States. With a culture that champions collaboration, continuous learning, and a relentless focus on customer success, brighthush empowers its teams to thrive in a fast‑moving industry. As part of our Corporate Synergies division, we are expanding our footprint in employee benefits support, and we’re looking for a dedicated professional to join our growing roster.

Why brighthush?

• Impactful Work – Your role will directly influence the experience of thousands of employees and the operational efficiency of our clients.
• Career Growth – We invest in internal mobility, mentorship programs, and leadership development to help you ascend to senior roles.
• Inclusive Culture – Diversity, equity, and inclusion are woven into every layer of our organization, ensuring every voice is heard.
• Competitive Compensation – A transparent pay structure, performance bonuses, and a comprehensive benefits package.
• Work-Life Balance – Flexible scheduling, generous PTO, and remote‑friendly policies.

Job Summary

As an Employee Benefits Customer Service Representative at brighthush, you will be the frontline advocate for our clients’ employees. Your primary mission is to resolve claims, answer benefit inquiries, and ensure seamless communication between clients, carriers, and internal stakeholders. You will handle complex issues with a 24‑hour turnaround, leveraging Salesforce and other tools to maintain meticulous records and deliver actionable insights.

Key Responsibilities

• Respond to employee benefit inquiries via phone, email, and chat, providing clear, accurate, and timely information.
• Investigate and resolve claims, pre‑certifications, and patient advocacy matters, ensuring compliance with carrier guidelines and client policies.
• Educate employees on optimal benefit utilization, cost‑effective plan options, and enrollment processes.
• Maintain detailed, up‑to‑date records in Salesforce, including case notes, resolution status, and client communications.
• Generate and analyze client reports to identify trends, gaps, and opportunities for improvement.
• Review Summary Plan Descriptions (SPDs) and benefit summaries for accuracy, updating documentation as needed.
• Serve as a primary resource for insurance billing, coding, employee group benefits, and plan description queries.
• Collaborate with cross‑functional teams—claims, underwriting, and client success—to streamline issue resolution.
• Monitor resolution timelines, ensuring all benefit issues and claims are closed within the designated 24‑hour window.
• Assist with member eligibility inquiries, enrollment entry, and coverage confirmation.
• Participate in continuous improvement initiatives, sharing insights and best practices to enhance service quality.

Essential Qualifications

• Minimum of 3 years’ experience in a customer service or call center environment, preferably within the insurance or benefits sector.
• Hands‑on experience with insurance carriers, brokers, or related vendors.
• Strong knowledge of eligibility claims, medical coding and billing, and benefit plan descriptions.
• Proficiency in Salesforce and Microsoft Office Suite (Word, Excel, Outlook).
• Exceptional verbal and written communication skills, with the ability to explain complex concepts simply.
• Outstanding organizational and multitasking capabilities, adept at prioritizing tasks under tight deadlines.
• Strong problem‑solving aptitude, with a proactive, solution‑oriented mindset.
• Collaborative team player who thrives in a fast‑paced, dynamic environment.
• Adaptable, detail‑oriented, and committed to delivering high‑quality service.
• Proficiency in Spanish (written and spoken) is a plus.

Preferred Qualifications

• Experience with benefit administration platforms (e.g., Workday, ADP, Gusto).
• Knowledge of ACA, HIPAA, and other regulatory frameworks governing employee benefits.
• Previous exposure to claims adjudication or patient advocacy roles.
• Certification in Customer Service Excellence or related fields.

Skills & Competencies

• Customer‑centric mindset with a passion for problem resolution.
• Analytical thinking and data‑driven decision making.
• Time management and prioritization under pressure.
• Effective cross‑functional communication and collaboration.
• Continuous learning and adaptability to new technologies.

Career Growth & Learning Opportunities

At brighthush, we believe in nurturing talent from the ground up. As a Customer Service Representative, you’ll have access to:

• Structured onboarding and mentorship programs.
• Regular training sessions on industry trends, new benefit products, and regulatory updates.
• Opportunities to transition into roles such as Claims Analyst, Client Success Manager, or Product Specialist.
• Leadership development tracks for high‑potential employees.
• Cross‑departmental projects that broaden your skill set and visibility.

Work Environment & Culture

brighthush fosters a collaborative, inclusive, and forward‑thinking culture. Our teams are empowered to innovate, experiment, and drive results. We celebrate diversity, encourage open dialogue, and prioritize employee well‑being. Whether you’re working remotely or in one of our modern office spaces, you’ll find a supportive environment that values your contributions.

Compensation & Benefits

We offer a transparent and competitive compensation package that reflects your experience, performance, and the value you bring to brighthush.

• Base Salary – $22,000 to $25,000 USD annually, with potential for performance‑based increases.
• Performance Bonuses – Quarterly bonuses tied to individual and team metrics.
• Health & Wellness – Comprehensive medical, vision, and dental plans, including telehealth services.
• Retirement Savings – 401(k) plan with company match up to 5%.
• Life & Disability Insurance – Company‑paid term life, short‑term and long‑term disability coverage.
• Paid Time Off – 18 days of PTO per year, 10 paid holidays, and 2 floating holidays.
• Flexible Work Arrangements – Remote options and flexible scheduling to support work‑life balance.
• Professional Development – Reimbursement for certifications, conferences, and continuing education.
• Employee Assistance Program – Confidential counseling and support services.

How to Apply

If you’re ready to make a tangible impact on employee benefit experiences and grow your career within a dynamic, supportive organization, we encourage you to apply today. Submit your resume and a brief cover letter outlining why you’re the ideal fit for brighthush’s Customer Service team.

Equal Opportunity Employer

brighthush is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic.