Remote Customer Service Agent II – Inbound Call Center Specialist for Healthcare Claims Support

About brighthush

brighthush is a leading provider of innovative benefits administration and care management software solutions that empower employers, health plans, and health care providers to deliver seamless, data‑driven care to their members. Founded in 2004, brighthush has grown into a global technology partner with a dedicated team of over 8,000 professionals who are passionate about transforming the way health benefits are managed and experienced. Our mission is to simplify the complex world of health benefits, enabling organizations to focus on what matters most: improving health outcomes and employee satisfaction.

As a remote‑first company, brighthush embraces flexibility, collaboration, and a culture of continuous learning. We believe that great talent can thrive anywhere, and we provide the tools, resources, and support necessary for our employees to succeed from any location in the United States.

Why Join brighthush?

• Impactful Work: Your role will directly influence the experience of thousands of customers navigating their health benefits, ensuring they receive accurate, timely information and support.
• Career Growth: We invest heavily in professional development, offering mentorship programs, cross‑functional training, and clear advancement pathways within our customer success, product, and operations teams.
• Inclusive Culture: brighthush is committed to fostering an environment where diversity, equity, and inclusion are not just buzzwords but everyday practices.
• Competitive Compensation: We offer a market‑competitive base salary, performance bonuses, and a comprehensive benefits package that includes health, dental, vision, and retirement plans.
• Work‑Life Balance: As a fully remote position, you can design your work environment to suit your lifestyle while enjoying flexible scheduling and generous paid time off.

Position Overview

As a Remote Customer Service Agent II at brighthush, you will serve as the frontline advocate for our UST customers, handling inbound and outbound calls related to healthcare claims. You will document interactions, research claim status, and act as the liaison between the claims department and external providers. Your dedication to exceptional customer service will help maintain brighthush’s reputation for reliability and responsiveness.

Key Responsibilities

• Receive and respond to inbound phone calls, providing clear, accurate information regarding customer inquiries and claim status.
• Initiate outbound calls to follow up on pending claims, resolve discrepancies, and gather additional information from providers.
• Document all customer interactions in our ticketing and tracking systems, ensuring data integrity and compliance with internal policies.
• Research customer claims within primary payor systems, verifying coverage details, claim adjudication, and payment status.
• Act as a liaison between the claims department and external providers, facilitating timely resolution of issues and ensuring seamless communication.
• Maintain a comprehensive understanding of covered plan benefits, including Medicare, Medicare Advantage, and other health plan offerings.
• Deliver the highest level of customer service on every call, adhering to brighthush’s service standards and quality metrics.
• Collaborate with cross‑functional teams (e.g., product, engineering, compliance) to provide feedback on system enhancements and process improvements.
• Perform additional duties as assigned to support the overall success of the customer service team.

Essential Qualifications

• High school diploma or equivalent; associate’s or bachelor’s degree preferred.
• 2–3 years of experience in healthcare claims operations, call center, or customer support roles.
• Strong verbal and written communication skills, with the ability to explain complex information in a clear, concise manner.
• Excellent attention to detail and problem‑solving abilities, ensuring accurate documentation and efficient resolution of customer issues.
• Proficiency in Microsoft Office applications, particularly Word and Excel, for data entry and reporting.
• Basic understanding of Medicare and Medicare Advantage plans, including eligibility, coverage, and claim processing.
• Experience using ticketing or CRM systems to track customer interactions and claims status.
• Ability to work independently in a remote environment, managing time effectively and maintaining high productivity.

Preferred Qualifications

• Experience with health benefits software platforms or claims management systems.
• Knowledge of primary payor systems and electronic health record (EHR) integration.
• Familiarity with HIPAA regulations and data privacy best practices.
• Previous experience in a remote or distributed team setting.
• Multilingual capabilities, especially in Spanish or other widely spoken languages.

Skills & Competencies

• Customer‑Centric Mindset: Passion for helping customers and a commitment to exceeding service expectations.
• Analytical Thinking: Ability to interpret data, identify trends, and propose actionable solutions.
• Adaptability: Comfortable navigating changing priorities and evolving processes.
• Team Collaboration: Strong interpersonal skills to work effectively with colleagues across departments.
• Technical Proficiency: Comfortable learning new software tools and troubleshooting basic technical issues.
• Time Management: Skilled at prioritizing tasks and meeting deadlines in a fast‑paced environment.

Career Growth & Learning Opportunities

At brighthush, we believe that investing in our people is the key to sustained success. As a Customer Service Agent II, you will have access to:

• Structured onboarding and continuous training programs covering product knowledge, compliance, and customer service best practices.
• Mentorship from senior customer success leaders who will guide your professional development.
• Opportunities to transition into specialized roles such as Claims Analyst, Customer Success Manager, or Product Support Engineer.
• Participation in cross‑functional projects that influence product roadmap and customer experience initiatives.
• Annual performance reviews with clear metrics and actionable feedback to help you advance within the organization.

Work Environment & Culture at brighthush

Our remote‑first culture is built on trust, transparency, and collaboration. You will enjoy:

• Flexible work hours that accommodate your personal schedule while meeting team and customer needs.
• Regular virtual team huddles, town halls, and social events to foster connection and camaraderie.
• A culture of open communication, where ideas are welcomed and feedback is valued.
• Access to cutting‑edge collaboration tools (Slack, Zoom, Asana) that keep you connected with teammates across the globe.
• Commitment to mental health and well‑being, with resources such as counseling services and wellness programs.

Compensation & Benefits

While specific salary ranges may vary based on experience and location, brighthush offers a competitive base salary that aligns with industry standards for remote customer service roles. In addition to your base pay, you will receive:

• Performance‑based bonuses tied to individual and team metrics.
• Health, dental, and vision insurance plans with employer contributions.
• 401(k) retirement plan with company match.
• Paid time off (vacation, sick leave, holidays) and flexible scheduling.
• Professional development stipend for courses, certifications, or conferences.
• Employee assistance program (EAP) and mental health resources.
• Remote work stipend to support your home office setup.

H1B Sponsorship

brighthush has a strong track record of sponsoring international talent. While we do not guarantee sponsorship for every role, we encourage qualified candidates who require H1B sponsorship to apply. Our immigration team will review each application on a case‑by‑case basis.

Ready to Make an Impact?

If you are a dedicated, customer‑focused professional with a passion for healthcare claims and a desire to work in a dynamic, remote environment, we want to hear from you. Join brighthush and become part of a team that is redefining the future of health benefits.

Click the link below to submit your application and take the first step toward an exciting career with brighthush.