Remote Healthcare Customer Service Specialist – Claims, Enrollment & Member Support – Join brighthush

About brighthush

brighthush is a forward‑thinking health‑tech partner that empowers individuals and organizations to navigate the complex world of health benefits with confidence and clarity. With a mission to simplify the patient experience, we provide innovative digital solutions that connect members, providers, and payers in a seamless ecosystem. Our team is built on a foundation of empathy, data‑driven insight, and a relentless commitment to quality. As a fully remote, high‑growth company, we offer the flexibility to work from anywhere in the United States while fostering a collaborative, inclusive culture that values every voice.

Why This Role Matters

In the ever‑evolving landscape of health insurance, clear communication and accurate information are the cornerstones of member satisfaction. As a Remote Healthcare Customer Service Specialist, you will be the frontline advocate for our members, ensuring they receive timely, accurate guidance on benefits, claims, enrollment, and billing. Your expertise will directly influence member trust, reduce claim denials, and support the overall health of our organization’s financial and operational performance.

Key Responsibilities

• Member Support & Inquiry Resolution: Respond to inbound member inquiries via phone, email, and chat regarding benefits, claims status, enrollment questions, and billing concerns.
• Claims Processing & Verification: Review submitted claims, verify processing requirements, and collaborate with the claims team to resolve payment discrepancies or denials.
• Enrollment & Billing Administration: Assist members and group administrators with enrollment transactions, policy changes, and billing activities in accordance with established guidelines.
• Education & Guidance: Provide clear, concise explanations of benefits, contractual provisions, and procedures to members, providers, and group administrators.
• Documentation & Quality Assurance: Maintain accurate, up‑to‑date records of all customer interactions, ensuring compliance with internal service standards and regulatory requirements.
• Multi‑System Navigation: Efficiently navigate multiple software applications simultaneously while delivering exceptional customer service.
• Cross‑Functional Collaboration: Work closely with internal teams—including claims, enrollment, and clinical professionals—to support appropriate managed care interventions and resolve complex cases.
• Continuous Improvement: Identify trends, provide feedback, and participate in initiatives that enhance service quality and operational efficiency.

Essential Qualifications

• High school diploma or GED (or equivalent).
• Minimum of 1 year of customer service, claims processing, or inbound call center experience.
• Prior exposure to healthcare, health insurance, medical information, or claims‑related operations.
• Strong verbal and written communication skills, with the ability to explain complex concepts in simple terms.
• Excellent problem‑solving, organizational, and time‑management abilities.
• Self‑motivated and capable of working independently in a remote, fast‑paced, quality‑driven environment.
• Proficiency in Microsoft Office, email, internet research, and navigating multiple software applications.

Preferred Qualifications

• 2–5 years of inbound call center experience, preferably within the health insurance sector.
• Experience with claims adjudication systems or enrollment platforms.
• Knowledge of HIPAA regulations and data privacy best practices.
• Previous remote work experience with a proven track record of meeting or exceeding performance metrics.
• Fluency in additional languages (Spanish, Mandarin, etc.) is a plus.

Skills & Competencies

• Customer‑Centric Mindset: A genuine desire to help members and a commitment to delivering a positive experience.
• Analytical Thinking: Ability to interpret data, identify root causes, and propose actionable solutions.
• Adaptability: Comfortable navigating changing policies, procedures, and technology tools.
• Team Collaboration: Strong interpersonal skills to work effectively with cross‑functional teams.
• Attention to Detail: Meticulous record‑keeping and adherence to compliance standards.
• Technology Savvy: Quick learner of new software and comfortable troubleshooting basic technical issues.

Career Growth & Learning Opportunities

At brighthush, we believe that professional development is a shared journey. As a member of our customer service team, you will have access to:

• Structured onboarding and mentorship programs that accelerate your learning curve.
• Regular training sessions on industry trends, new product features, and regulatory updates.
• Opportunities to cross‑train in related functions such as claims adjudication, enrollment, or data analytics.
• Clear career pathways to roles such as Senior Customer Support Specialist, Team Lead, or Operations Manager.
• Access to an internal knowledge base and collaboration tools that keep you connected to the latest best practices.

Work Environment & Culture at brighthush

Our remote‑first culture is built on trust, transparency, and a shared commitment to excellence. You’ll experience:

• Flexible work hours that accommodate your personal schedule while meeting team needs.
• Regular virtual town halls, team‑building events, and informal “coffee chat” sessions to foster community.
• A culture of recognition where achievements are celebrated through shout‑outs, spot bonuses, and peer‑to‑peer awards.
• Inclusive policies that support work‑life balance, mental health, and continuous learning.
• A collaborative environment where ideas are valued and innovation is encouraged.

Compensation, Perks & Benefits

While specific salary ranges may vary based on experience, we offer a competitive compensation package that includes:

• Competitive base salary aligned with industry standards for remote customer service roles.
• Performance‑based bonuses and incentive programs.
• Comprehensive health, dental, and vision insurance plans.
• 401(k) retirement plan with company match.
• Paid time off (PTO), holidays, and flexible sick leave.
• Professional development stipend and access to online learning platforms.
• Technology stipend to support a home‑office setup.
• Employee assistance program (EAP) for mental health and wellness support.

Why Join brighthush?

Choosing brighthush means becoming part of a mission‑driven team that is reshaping how people experience health benefits. You’ll enjoy:

• Working from anywhere in the United States with a fully remote setup.
• Collaborating with passionate professionals who are dedicated to improving member outcomes.
• Having a direct impact on member satisfaction and the financial health of the organization.
• Access to continuous learning and clear advancement opportunities.
• Being part of a culture that values diversity, equity, and inclusion.

How to Apply

If you are ready to bring your customer‑service expertise to a dynamic, growth‑oriented company, we encourage you to apply today. Click the link below to submit your application and join the brighthush family.