Provider Claims Customer Service Representative – Remote – Healthcare Claims Support Specialist (Full‑Time, Home‑Based, High‑Impact Role)

About brighthush

brighthush stands at the forefront of technology‑driven healthcare operations, turning complex claims workflows into seamless, data‑rich experiences for payers, providers, and patients alike. With a proud legacy spanning more than 25 years, we have consistently delivered scalable, high‑quality solutions that streamline claims processing, elevate customer experience, and unlock operational efficiencies. Our mission is simple yet powerful: empower every stakeholder in the healthcare ecosystem with the tools, insights, and confidence they need to focus on what truly matters—improving patient outcomes and delivering exceptional care.

Why Join brighthush?

When you become part of brighthush, you’re not just filling a role—you’re stepping into a culture that values innovation, accountability, and inclusivity. We champion a remote work model that blends flexibility with structure, ensuring you can thrive personally and professionally. Here’s what makes brighthush a standout place to grow:

• Impactful Work: Your daily interactions directly influence the efficiency of provider networks, the accuracy of claim adjudication, and ultimately the quality of patient care.
• Career Momentum: Clear, merit‑based pathways let you move from frontline support to analytical, process‑improvement, or leadership positions.
• Learning Ecosystem: From structured onboarding to ongoing mentorship, we invest in continuous skill development and industry knowledge.
• Inclusive Community: Diversity, equity, and inclusion are woven into our DNA—every voice is heard, every idea is valued.
• Competitive Compensation & Benefits: We offer a robust package that protects your health, finances, and future.

Position Overview

We are seeking an experienced Provider Claims Customer Service Representative to join our fully remote contact center team. In this full‑time role, you will serve as the primary point of contact for healthcare provider representatives seeking real‑time claim status updates. Your ability to navigate multiple systems, communicate clearly, and maintain data integrity will be critical to our mission of delivering flawless claims support.

Schedule & Compensation

• Schedule: Monday‑Friday, 11:00 am – 7:30 pm EST (core window with flexible start/end times)
• Hourly Pay: $16.00 – $17.00, commensurate with experience, performance, and tenure
• Benefits: Health, dental, vision, 401(k) match, paid time off, and more (see full package below)
• Equipment: All necessary hardware and high‑speed internet stipend provided—no out‑of‑pocket expenses

Key Responsibilities

• Answer inbound calls from provider representatives regarding claim status inquiries, ensuring a courteous and professional experience.
• Research claim information across client systems and platforms, verifying accuracy and completeness before communicating results.
• Provide clear, actionable information to callers, translating complex data into understandable insights.
• Confirm all relevant data points—claim number, provider ID, patient details—before sharing status to maintain compliance and data integrity.
• Navigate multiple applications simultaneously while maintaining a conversational flow with callers.
• Document every interaction and action in the system according to established procedures, ensuring audit readiness.
• Identify and flag inquiries that require escalation, following the correct escalation path and documentation.
• Maintain a high level of professionalism, courtesy, and empathy throughout every provider interaction.
• Consistently meet or exceed productivity, quality, attendance, and service metrics.
• Participate in ongoing training, coaching, and professional development activities to sharpen skills and stay current.
• Adhere to privacy, security, client, and organizational policies and procedures, including HIPAA compliance.

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.

Essential Qualifications

• Minimum of 2 years of customer service or contact center experience, preferably in a high‑volume environment.
• Excellent verbal communication and active listening skills, with the ability to articulate information clearly 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 that cover industry fundamentals, system navigation, and soft‑skill development.
• Mentorship from experienced professionals in healthcare operations, giving you real‑world insights and guidance.
• Cross‑functional exposure to claims adjudication, digital mailroom, and member communications—broadening your skill set.
• 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—fueling your professional development.

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 with employer contributions.
• 401(k) plan with company match to help you build a secure future.
• Paid time off, sick leave, and holidays—because rest is essential for performance.
• Employee assistance program and wellness resources to support mental and physical health.
• Professional development stipend and tuition reimbursement for relevant courses.
• All‑necessary equipment and high‑speed internet stipend—no out‑of‑pocket expenses.
• Regular team‑building events and virtual social gatherings to strengthen camaraderie.

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.

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.