Experienced Group Health Customer Service Representative – Client Relations & Claims Management Specialist at brighthush

About brighthush

brighthush is a leading, high‑growth player in the healthcare and insurance services sector, recognized for its innovative approach to claims management and independent medical review. With a portfolio that spans workers’ compensation, disability, auto, and group health carriers, we process more than 200,000 claims annually, delivering timely, accurate, and compliant solutions to our clients. Our culture is built on collaboration, continuous improvement, and a commitment to excellence, making brighthush an exciting place to build a career.

Why Join brighthush?

At brighthush, we believe that our people are our greatest asset. We offer a dynamic, remote‑first work environment that empowers you to balance professional growth with personal flexibility. Whether you’re a seasoned professional or just starting out, you’ll find:

• Competitive Compensation: Base salary commensurate with experience, performance‑based bonuses, and a comprehensive benefits package.
• Career Development: Structured learning paths, mentorship programs, and opportunities to cross‑train across business units.
• Inclusive Culture: A diverse, supportive community that values every voice and encourages innovation.
• Work‑Life Balance: Generous paid time off, flexible scheduling, and a fully remote setup with the latest technology.

Key Responsibilities

As a Group Health Customer Service Representative, you will be the linchpin between our clients, our technical teams, and our operations. Your day‑to‑day tasks will include:

• Case Intake & Verification: Receive new referrals, verify completeness, and enter data into the brighthush system (AccessDS). Draft initial case files and coordinate with clients to gather missing information.
• Document Management: Organize and create medical document listings as required by clients, ensuring compliance with special handling protocols.
• Case Oversight: Monitor all active cases, track progress against deadlines, and flag any delays or issues to the appropriate stakeholders.
• Assignment & Scheduling: Allocate new cases to physicians based on location, availability, jurisdictional rules, and client preferences. Verify conflict‑of‑interest checks before assignment.
• Client Communication: Provide regular updates to clients on case status, respond to inquiries, and ensure that all documentation meets client expectations.
• Quality Assurance: Review completed cases for accuracy, completeness, and adherence to internal standards and client guidelines.
• Process Improvement: Identify bottlenecks, propose workflow enhancements, and collaborate with cross‑functional teams to streamline operations.

Essential Qualifications

• Minimum 1 year of administrative or clerical experience in a business office setting.
• Preferred experience in healthcare, medical office, or insurance claims environments.
• Proficiency with Apple OS, Google Chrome, Gmail, and the brighthush AccessDS platform.
• Exceptional written and verbal communication skills, with the ability to engage confidently with clients, claimants, and physicians.
• Strong organizational skills and meticulous attention to detail in a fast‑paced environment.
• Ability to manage multiple priorities, adapt to changing deadlines, and maintain focus under pressure.
• Associate’s Degree preferred; Bachelor’s Degree a plus.

Preferred Qualifications & Skills

• Experience with medical terminology and claims processing workflows.
• Knowledge of HIPAA regulations and data privacy best practices.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Experience with remote collaboration tools (Zoom, Teams, Slack).
• Demonstrated ability to work independently and as part of a distributed team.

Technical Requirements for Remote Work

As a remote employee, you will be responsible for:

• Providing a reliable, high‑speed internet connection to support uninterrupted work.
• Maintaining a secure, dedicated workspace that meets brighthush’s data security standards.
• Using the company‑provided Apple laptop and peripheral equipment, along with a media stipend to optimize your home office.

Career Growth & Learning Opportunities

At brighthush, we invest in your professional development:

• Structured onboarding program with mentorship from senior team members.
• Access to internal e‑learning courses covering industry regulations, technology tools, and soft‑skill development.
• Opportunities to lead cross‑functional projects, enhancing your leadership and project management experience.
• Clear promotion pathways from Customer Service Representative to Senior Representative, Team Lead, or Manager roles.

Company Culture & Work Environment

Our culture is defined by:

• Collaboration: Regular virtual huddles, open communication channels, and a culture of knowledge sharing.
• Innovation: Encouragement to experiment, propose new ideas, and implement process improvements.
• Recognition: Employee of the Month, peer‑to‑peer shout‑outs, and performance‑based bonuses.
• Well‑Being: Mental health resources, virtual fitness classes, and flexible work hours to support work‑life harmony.

Compensation & Benefits

While base salary will be determined by experience and qualifications, you can expect:

• Competitive base salary aligned with industry standards.
• Performance‑based bonuses tied to individual and team metrics.
• Health, dental, and vision insurance for you and your dependents.
• Short‑term and long‑term disability coverage.
• Basic life insurance and voluntary life insurance options.
• 401(k) plan with company match.
• Generous paid time off (vacation, sick leave, personal days).
• Pet insurance and other voluntary benefits (hospital indemnity, critical illness, accident indemnity).
• Apple equipment and media stipend for remote workspace.

How to Apply

If you are a proactive, detail‑oriented professional who thrives in a fast‑moving, client‑focused environment, we want to hear from you. Submit your application through our careers portal or click the link below to apply directly:

Apply to brighthush Today

Join brighthush – Where Your Career Meets Impact

At brighthush, you will play a pivotal role in ensuring that our clients receive the highest quality service and that claims are processed accurately and efficiently. Your contributions will directly influence client satisfaction, operational excellence, and the overall success of our organization. If you are ready to bring your expertise to a forward‑thinking, growth‑oriented company, apply now and become part of the brighthush family.