Remote Customer Service Associate – Payer Solutions Operations Specialist (Precertification & Provider Status) – Join brighthush’s Innovative Healthcare Team

About brighthush and the Healthcare Innovation Landscape

brighthush is a forward‑thinking healthcare partner that empowers patients, providers, and payers to navigate the complex world of health coverage with confidence and clarity. With a mission to streamline access to care and enhance the quality of service delivery, brighthush has become a trusted name in payer solutions across the United States. Our remote teams are built on a foundation of collaboration, continuous learning, and a relentless focus on customer satisfaction.

As the healthcare industry evolves, the demand for skilled customer service professionals who can bridge the gap between technology, policy, and people has never been higher. At brighthush, we are expanding our Payer Solutions Operations team and looking for a dedicated Remote Customer Service Associate to play a pivotal role in supporting our precertification and provider status processes.

Why This Role Is a Game‑Changer for Your Career

In this position, you will become the frontline advocate for healthcare professionals and third‑party administrators, ensuring that every inquiry about precertification or provider status is handled with precision, empathy, and speed. Your work will directly impact the efficiency of care delivery, the satisfaction of our partners, and the overall success of brighthush’s mission to simplify healthcare access.

Key Responsibilities

• Customer & Provider Interaction: Serve as the primary point of contact for healthcare professionals and third‑party administrators seeking assistance with precertification and provider status inquiries. Deliver timely, accurate, and courteous support across phone, email, fax, and web channels.
• Data Accuracy & Documentation: Maintain meticulous records of all interactions, ensuring that every call is logged with the correct status, outcome, and follow‑up actions. Use our CRM and documentation tools to keep data clean and audit‑ready.
• Call Center Metrics Management: Monitor and manage key performance indicators such as Average Speed of Answer (ASA), After‑Call Work (ACW), and Schedule Adherence. Analyze trends, identify bottlenecks, and collaborate with supervisors to improve overall team performance.
• Precertification Expertise: Handle complex precertification requests from healthcare providers, verifying eligibility, coverage details, and authorization requirements. Coordinate with internal teams to expedite approvals and resolve any discrepancies.
• Provider Status Verification: Assist clients in confirming the active status of providers within our network. Cross‑reference multiple data sources, update records, and communicate findings to stakeholders.
• Multi‑Channel Support: Respond to incoming faxes, mail inquiries, web requests, and emails in a timely manner, ensuring that all communication channels are seamlessly integrated into the customer experience.
• Quality Assurance & Compliance: Adhere to established call protocols, quality standards, and regulatory requirements. Participate in regular quality reviews, coaching sessions, and process improvement initiatives.
• Team Collaboration: Work closely with cross‑functional teams—including billing, coding, and IT—to resolve complex issues and share best practices. Contribute to a culture of continuous improvement and knowledge sharing.

Essential Qualifications

• Experience: Minimum of 2 years in a customer service or call center environment, preferably within the healthcare or insurance sector.
• Medical Knowledge: Familiarity with medical coding and billing concepts, as well as an understanding of precertification processes and provider network management.
• Communication Skills: Exceptional verbal and written communication abilities, with a strong emphasis on clarity, empathy, and professionalism.
• Technical Proficiency: Comfortable using Microsoft Office Suite (Word, Excel, Outlook) and CRM systems. Ability to learn new software quickly.
• Analytical Mindset: Strong attention to detail, analytical thinking, and a commitment to quality in every task.
• Time Management: Proven ability to manage multiple priorities, meet deadlines, and maintain composure in a fast‑paced environment.
• Typing Speed: Minimum 40 words per minute with high accuracy.
• Education: High School Diploma or GED equivalent. A college degree or relevant certifications (e.g., Certified Medical Assistant, Certified Billing Specialist) is a plus.

Preferred Qualifications

• Experience working in a remote or virtual call center setting.
• Knowledge of healthcare regulations such as HIPAA, HITECH, and CMS guidelines.
• Prior exposure to payer solutions or health insurance operations.
• Experience with call center metrics dashboards and performance reporting.
• Multilingual abilities (Spanish, French, or other languages) are highly valued.

Core Skills & Competencies

• Customer‑centric mindset with a passion for problem solving.
• Strong organizational skills and the ability to prioritize tasks effectively.
• Adaptability to changing processes, technologies, and regulatory landscapes.
• Team player who thrives in a collaborative, high‑energy environment.
• Proactive attitude toward continuous learning and professional growth.

Career Growth & Learning Opportunities

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

• Structured onboarding and mentorship programs to accelerate your integration into the team.
• Regular training sessions on medical coding, billing updates, and new technology tools.
• Clear career pathways that can lead to roles such as Senior Customer Service Specialist, Team Lead, or Operations Analyst.
• Opportunities to participate in cross‑functional projects, giving you exposure to broader business functions.
• Access to an online learning portal with courses on healthcare compliance, data analytics, and leadership development.

Work Environment & Company Culture

brighthush champions a culture of flexibility, transparency, and innovation. Key highlights include:

• Fully remote work model with a flexible schedule that respects work‑life balance.
• Regular virtual team huddles, town halls, and social events to foster connection.
• Inclusive environment that celebrates diversity and encourages diverse perspectives.
• Commitment to employee well‑being through wellness programs, mental health resources, and supportive leadership.
• Recognition programs that celebrate individual and team achievements.

Compensation, Perks, and Benefits

• Competitive Salary: Market‑aligned compensation based on experience and performance.
• Health & Wellness: Comprehensive medical, dental, and vision plans available to eligible employees.
• Retirement Savings: 401(k) plan with company match once eligibility requirements are met.
• Paid Time Off: Generous PTO, sick leave, and holiday schedule.
• Professional Development: Reimbursement for industry certifications, conferences, and continuing education.
• Technology Stipend: Home office equipment allowance to ensure a productive remote workspace.
• Employee Assistance Program: Confidential counseling and support services.

Ready to Make an Impact?

If you are a motivated, detail‑oriented customer service professional with a passion for healthcare and a desire to work in a dynamic, remote environment, we invite you to apply for the Remote Customer Service Associate position at brighthush. Join a team that values your expertise, supports your growth, and empowers you to deliver exceptional service to patients, providers, and partners across the nation.

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