Remote Healthcare Member Experience Specialist – Clinical Support & Claims Expert, Customer Service Representative – Global Health Innovation Team at brighthush

About brighthush

brighthush isn’t just a company; it’s a global movement that reimagines how people experience health and wellness. With a presence on five continents and a community of more than 25,000 passionate professionals, we fuse cutting‑edge technology, data‑driven insights, and an unwavering commitment to human connection. Our mission is clear: to elevate every touchpoint in the member journey—from clinical support and case management to payment integrity and analytics—so that care is not only accessible but also seamless, compassionate, and truly member‑centric.

Why Join brighthush?

At brighthush, we believe that a career should be a journey, not a destination. From the front lines of customer service to leadership, product innovation, and strategic consulting, every role offers a clear path forward. Our S.O.A.R. philosophy—Spark Curiosity, One Team, One Direction, Action for Results, Right by Right Purpose—guides every interaction, ensuring that each team member feels empowered, connected, and purposeful. When you join brighthush, you become part of a culture that celebrates curiosity, rewards collaboration, and relentlessly pursues excellence.

Role Overview

As a Remote Healthcare Member Experience Specialist, you will be the compassionate human connection that transforms routine inquiries into memorable experiences. You’ll handle inbound calls, resolve complex issues, and contribute to continuous improvement initiatives—all while working from the comfort of your own home. This role is ideal for individuals who thrive in a fast‑paced, data‑driven environment and who are passionate about making a tangible difference in people’s health journeys.

Key Responsibilities

• Answer inbound member and patient calls with professionalism, empathy, and a solution‑oriented mindset.
• Investigate and resolve inquiries related to clinical services, case management, provider interactions, payment questions, and claims processing.
• Document all interactions accurately in our secure, cloud‑based CRM system, ensuring data integrity and compliance with HIPAA regulations.
• Collaborate with cross‑functional teams—clinical, analytics, and technology—to troubleshoot and close complex cases.
• Meet or exceed daily quality and customer satisfaction metrics, contributing to team goals and continuous improvement.
• Participate in ongoing training sessions, virtual workshops, and skill‑building modules to stay current on industry best practices and product updates.
• Provide feedback on process gaps and suggest enhancements that improve member experience and operational efficiency.
• Act as a brand ambassador, representing brighthush’s values and commitment to member care in every interaction.
• Assist in the development and refinement of knowledge base articles and FAQs to empower self‑service for members.
• Analyze call data to identify trends, flag potential systemic issues, and recommend proactive solutions.
• Support the implementation of new tools and workflows, ensuring smooth adoption across the remote team.

Essential Qualifications

• Minimum of 1 year experience in a call center or customer service environment, preferably within healthcare.
• High school diploma or equivalent; associate or bachelor’s degree is a plus.
• Strong verbal and written communication skills in English; bilingual (Spanish, French, or other languages) is highly valued.
• Typing speed of at least 25 words per minute.
• Reliable high‑speed internet connection (minimum 10 Mbps upload, 25 Mbps download).
• Secure, private workspace at home that meets privacy and security standards.
• Flexible availability, including weekends and holidays, to support a 24/7 service model.
• Proficiency with computer applications, including Microsoft Office Suite, web browsers, and basic troubleshooting.
• Demonstrated ability to handle high call volumes while maintaining a calm, professional demeanor.

Preferred Qualifications

• Experience with healthcare claims, payment integrity, or member engagement platforms.
• Knowledge of HIPAA regulations and data privacy best practices.
• Prior exposure to virtual training environments and remote collaboration tools.
• Demonstrated ability to work autonomously while maintaining high levels of accountability.
• Experience with CRM systems such as Salesforce or Zendesk.
• Familiarity with analytics dashboards and the ability to translate data insights into actionable improvements.

Core Competencies

• Customer‑centric mindset with a passion for exceeding expectations.
• Strong problem‑solving skills and the ability to think critically under pressure.
• Excellent interpersonal skills, capable of building rapport quickly with diverse members.
• Adaptability to evolving processes, technologies, and industry trends.
• Team player who thrives in a collaborative, fast‑paced environment.
• Commitment to continuous learning and personal growth.
• High emotional intelligence and resilience in handling sensitive member concerns.

Career Growth & Development

At brighthush, 90% of our leaders began their journey as Customer Service Representatives. We invest heavily in your professional growth through:

• Structured onboarding and continuous learning programs that cover technical, regulatory, and soft‑skill development.
• Mentorship from senior leaders and subject‑matter experts across clinical, analytics, and product teams.
• Clear career ladders that span from frontline support to managerial, analytical, and product roles.
• Access to tuition reimbursement for relevant certifications and degree programs.
• Regular performance reviews with actionable feedback and development plans.
• Opportunities to lead cross‑functional projects, hackathons, and process improvement initiatives.
• Annual leadership development workshops and global conferences to broaden your perspective.
• Dedicated learning budget for industry conferences, webinars, and professional certifications.
• Internal mobility programs that encourage lateral moves into new functional areas.

Work Environment & Culture

Our remote work model empowers you to balance professional responsibilities with personal commitments. You’ll be part of a vibrant, inclusive community that values:

• Transparency and open communication across all levels.
• Recognition of achievements through peer‑to‑peer shout‑outs and quarterly awards.
• Wellness initiatives, including virtual fitness classes, mindfulness sessions, and mental health resources.
• Employee engagement programs such as hackathons, volunteer days, and social events.
• A culture that celebrates diversity, equity, and inclusion, ensuring every voice is heard.
• Access to a digital collaboration hub that connects you with colleagues worldwide.
• Regular virtual town halls and Q&A sessions with executive leadership.
• Flexible scheduling that respects work‑life boundaries while meeting service commitments.

Compensation & Benefits

Competitive hourly rates range from $11.00 to $14.00, with bilingual representatives earning $15.00 per hour. Additional compensation includes:

• Performance‑based incentives tied to quality and customer satisfaction metrics.
• Daily pay option for immediate earnings.
• Comprehensive health, dental, and vision coverage available after 90 days.
• Life insurance, short‑term and long‑term disability coverage.
• Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
• 401(k) plan with employer match.
• Paid time off (PTO), paid holidays, and paid parental leave.
• Employee Assistance Program (EAP) for mental health and counseling support.
• Tuition reimbursement for approved educational pursuits.
• Access to a wellness stipend for gym memberships, meditation apps, or other health‑related expenses.
• Annual stipend for professional development and conference attendance.

How to Apply

Ready to make a difference in the lives of members and patients while advancing your career? Submit your application through our career portal or click the link below to start your journey with brighthush.

Apply to this Remote Healthcare Member Experience Specialist position at brighthush

Equal Opportunity Employer

brighthush is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees, veterans, and individuals with disabilities.