Remote Customer Services Concierge Support Specialist – Claims Processing & Client Relations – Intermediate Level

About brighthush

brighthush is a leading health insurance provider that has been delivering innovative, customer‑centric solutions since 1939. With a workforce of over 8,000 dedicated professionals, brighthush is committed to creating a workplace where meaningful work meets personal growth. Our mission is to empower individuals and communities by providing reliable, accessible, and high‑quality health coverage. As a remote‑first organization, we blend cutting‑edge technology with a culture of collaboration, ensuring that every team member can thrive from anywhere in the United States.

Why Join brighthush?

At brighthush, we believe that our people are our greatest asset. We offer a dynamic, inclusive environment where your expertise is valued and your career trajectory is supported. As a Remote Customer Services Concierge Support Specialist, you will play a pivotal role in ensuring that our third‑party administrators receive the highest level of service, directly impacting the satisfaction of our policyholders and partners.

Key Responsibilities

• Back‑End Claims Processing: Utilize advanced claim management systems to accurately process and adjust claims, ensuring compliance with regulatory standards and internal policies.
• Front‑End Adjustments: Handle complex adjustments and resolve discrepancies in a timely manner, maintaining a high level of accuracy.
• Special Processing Assignments: Take ownership of high‑priority or specialized tasks, coordinating with cross‑functional teams to achieve resolution.
• End‑to‑End Claims Lifecycle: Understand the full claims journey—from initial submission to final settlement—allowing you to anticipate issues and streamline workflows.
• Performance Metrics: Meet or exceed established KPIs such as turnaround time, accuracy rate, and customer satisfaction scores.
• Written Correspondence: Draft clear, professional responses to provider and claimant inquiries, ensuring all communications are consistent with brighthush’s brand voice.
• Mission Alignment: Champion brighthush’s commitment to meaningful work by delivering exceptional service and fostering a positive team culture.
• Team Collaboration: Actively contribute to a supportive, high‑performing team environment, sharing best practices and celebrating collective successes.

Essential Qualifications

• High School Diploma, GED, or equivalent, or 1 year of relevant experience in lieu of formal education.
• 1–3 years of experience in claims processing, customer service, or a related field.
• Proven ability to troubleshoot and resolve complex claims issues independently.
• Strong analytical skills with meticulous attention to detail.
• Excellent written and verbal communication skills, capable of drafting professional correspondence.
• Self‑motivated, dependable, and capable of working autonomously in a remote setting.
• Positive attitude and a collaborative spirit, thriving in a team‑oriented culture.

Preferred Qualifications

• Experience with claims management software (e.g., SAP, Oracle, or proprietary systems).
• Background in health insurance or third‑party administration.
• Knowledge of regulatory compliance standards such as HIPAA, ACA, and state‑specific guidelines.
• Previous remote work experience with a proven track record of meeting deadlines and maintaining high productivity.
• Certification in claims processing or related fields (e.g., Certified Professional Claims Adjuster).

Skills & Competencies

• Problem‑Solving: Ability to analyze complex situations, identify root causes, and implement effective solutions.
• Time Management: Prioritize tasks efficiently to meet tight deadlines while maintaining quality.
• Adaptability: Thrive in a fast‑changing environment, quickly learning new tools and processes.
• Customer‑Centric Mindset: Deliver exceptional service, anticipating client needs and exceeding expectations.
• Collaboration: Work seamlessly with cross‑functional teams, fostering open communication and shared success.
• Technology Proficiency: Comfortable navigating multiple software platforms, data entry, and reporting tools.

Career Growth & Learning Opportunities

At brighthush, we invest in your professional development. You will have access to:

• Comprehensive onboarding and continuous training programs tailored to your role.
• Mentorship from seasoned industry experts.
• Opportunities to cross‑train in related functions such as underwriting, compliance, or analytics.
• Clear career pathways, from Specialist to Senior Specialist, Manager, and beyond.
• Regular performance reviews and personalized development plans.

Work Environment & Culture

brighthush’s culture is built on trust, transparency, and teamwork. As a remote employee, you will enjoy:

• Flexible work hours that accommodate your personal schedule.
• Regular virtual team meetings, town halls, and social events to foster connection.
• A supportive leadership team that values feedback and encourages innovation.
• Access to cutting‑edge collaboration tools (Slack, Microsoft Teams, Zoom).
• Annual in‑person gatherings for networking and skill‑building.

Compensation & Benefits

While specific salary ranges are tailored to experience and location, brighthush offers a competitive compensation package that includes:

• Base salary commensurate with industry standards.
• Performance‑based bonuses tied to individual and team metrics.
• Health, dental, and vision insurance plans.
• 401(k) retirement plan with company match.
• Paid time off, holidays, and sick leave.
• Professional development stipend and tuition reimbursement.
• Wellness programs, including virtual fitness classes and mental health resources.

How to Apply

Ready to take the next step in your career and join a team that values innovation, collaboration, and impact? Click the link below to submit your application and become part of brighthush’s mission to make health coverage accessible and meaningful for all.