Provider Claims Customer Service Representative – Remote – Healthcare Claims Support Specialist

About brighthush

brighthush is a leading technology‑driven partner in the healthcare operations space, dedicated to transforming the way payers, providers, and patients interact. With a legacy of over 25 years in the industry, brighthush has built a reputation for delivering high‑quality, scalable solutions that streamline claims processing, enhance customer experience, and drive operational efficiency. Our mission is simple: to empower healthcare stakeholders with the tools and insights they need to focus on what matters most—improving patient outcomes and delivering exceptional care.

Position Overview

We are looking for an experienced Provider Claims Customer Service Representative to join our remote contact center team. This full‑time role operates 100% from home, providing critical support to healthcare provider representatives who need timely, accurate claim status information. The ideal candidate will thrive in a fast‑paced, performance‑driven environment, delivering clear communication and exceptional service while navigating multiple systems with ease.

Schedule & Compensation

• Schedule: Monday‑Friday, 11:00 am – 7:30 pm EST (flexible within the core window)
• Pay: $16.00 – $17.00 per hour, commensurate with experience and performance
• Competitive benefits package (health, dental, vision, 401(k) match, paid time off, and more)
• All necessary equipment provided (high‑speed internet, headset, phone, and secure VPN access)

Key Responsibilities

• Answer inbound calls from healthcare provider representatives regarding claim status inquiries.
• Research claim information using client systems and platforms, ensuring accuracy and completeness.
• Communicate claim details clearly and professionally, providing actionable information to callers.
• Verify and confirm all relevant data before sharing claim status to maintain compliance and data integrity.
• Navigate multiple applications simultaneously while maintaining a conversational flow with callers.
• Document all interactions and actions in the system according to established procedures.
• Identify and flag inquiries that require escalation, following the correct escalation path.
• Maintain a high level of professionalism and courtesy throughout every provider interaction.
• Consistently meet or exceed productivity, quality, attendance, and service metrics.
• Participate in ongoing training, coaching, and professional development activities.
• Adhere to privacy, security, client, and organizational policies and procedures.

Role Expectations

Success in this role demands a blend of technical proficiency, customer‑centric mindset, and self‑discipline. You will be expected to:

• Handle a steady volume of inbound provider calls with confidence and composure.
• Research claim information swiftly and accurately, leveraging multiple data sources.
• Manage multiple systems concurrently while engaging callers in real‑time.
• Communicate complex information in a clear, concise, and professional manner.
• Follow established processes and protocols, escalating issues when necessary.
• Work independently in a fully remote environment, maintaining productivity and focus.
• Accept feedback and coaching to continuously improve performance.
• Adapt quickly to evolving procedures, client requirements, and business priorities.

Required Qualifications

• Minimum of 2 years of customer service or contact center experience.
• Excellent verbal communication and active listening skills.
• Ability to articulate information clearly, accurately, and professionally over the phone.
• Strong attention to detail and a commitment to data accuracy.
• Proficiency in navigating multiple computer systems while handling calls.
• Effective workload management to meet productivity and quality expectations.
• Self‑motivated and collaborative, capable of working independently within a remote team.
• Reliable attendance and strict adherence to the established work schedule.

Preferred Qualifications

• Experience supporting healthcare providers, provider offices, or medical billing organizations.
• Familiarity with HIPAA regulations, healthcare claims terminology, and payer processes.
• Background in researching medical claim status within payer, health plan, TPA, or managed care systems.
• Knowledge of common claim statuses (paid, denied, pending, in‑process) and their implications.
• Experience working within contact center metrics such as average handle time, quality scores, productivity, and schedule adherence.
• Comfortable navigating multiple systems simultaneously while assisting callers.

Skills & Competencies

• Customer‑first mindset with a passion for problem solving.
• Strong analytical and research skills.
• Excellent time‑management and organizational abilities.
• Adaptability to changing priorities and processes.
• Proficiency with CRM and call‑center software.
• Commitment to maintaining confidentiality and data security.
• Team player who thrives in a collaborative, remote environment.

Career Growth & Learning Opportunities

At brighthush, we believe in investing in our people. As a Provider Claims Customer Service Representative, you will have access to:

• Structured onboarding and continuous training programs.
• Mentorship from experienced professionals in healthcare operations.
• Cross‑functional exposure to claims adjudication, digital mailroom, and member communications.
• Clear career pathways to roles such as Claims Analyst, Process Improvement Specialist, or Team Lead.
• Regular performance reviews and goal‑setting sessions to align your growth with company objectives.
• Access to industry conferences, webinars, and certifications.

Work Environment & Company Culture

brighthush fosters a culture of innovation, accountability, and inclusivity. Our remote team enjoys:

• Flexible work hours within core windows to support work‑life balance.
• Transparent communication channels and regular virtual team meetings.
• A supportive environment where feedback is encouraged and recognized.
• Opportunities to contribute ideas that shape our processes and technology.
• A commitment to diversity, equity, and inclusion across all levels.

Compensation, Perks, and Benefits

Beyond competitive hourly pay, brighthush offers a comprehensive benefits package designed to support your health, well‑being, and financial security:

• Health, dental, and vision insurance plans.
• 401(k) plan with company match.
• Paid time off, sick leave, and holidays.
• Employee assistance program and wellness resources.
• Professional development stipend and tuition reimbursement.
• All‑necessary equipment and high‑speed internet stipend.
• Regular team‑building events and virtual social gatherings.

Work‑From‑Home Requirements

• High‑speed internet connection (minimum 25 Mbps download, 5 Mbps upload).
• Directly hardwired connection to your modem for stability.
• Dedicated, quiet workspace free from distractions.
• Compatible headset and phone with noise‑cancellation.
• Secure VPN access to protect company data.

Why You’ll Love Working at brighthush

• Fully Remote: Work from the comfort of your home while staying connected to a vibrant team.
• Competitive Pay: Earn a rate that reflects your experience and performance.
• Comprehensive Benefits: Protect your health and future with top‑tier insurance and retirement plans.
• Equipment Provided: Receive all the tools you need to succeed—no out‑of‑pocket expenses.
• Career Growth: Join a dynamic, supportive environment that values your expertise and encourages advancement.
• Impactful Work: Contribute to processes that directly support providers, payers, and patients across the country.
• Inclusive Culture: Thrive in a workplace that celebrates diversity and fosters collaboration.

How to Apply

Ready to take the next step in your career? Submit your application through our portal and join the brighthush team where your skills will make a real difference in the healthcare ecosystem.