Remote Provider Claims Customer Service Specialist – Healthcare Operations & Claims Verification – Entry Level

About brighthush

brighthush is a leading healthcare operations partner that empowers payers, providers, and patients with cutting‑edge administrative, operational, and workflow technology services. With a mission to streamline claims processing, enhance data accuracy, and elevate customer experience, brighthush has become a trusted ally for health plans across the United States. Our remote‑first culture empowers employees to work from anywhere while fostering collaboration, innovation, and continuous learning. If you’re passionate about healthcare, thrive in a fast‑paced environment, and want to make a tangible impact on the lives of millions, brighthush is the place to grow your career.

Why Join brighthush?

At brighthush, we believe that the best solutions come from diverse, talented teams who are empowered to take ownership. As a Remote Provider Claims Customer Service Specialist, you’ll be at the forefront of our claims verification and customer support operations, ensuring that every claim is processed accurately and efficiently. You’ll work alongside seasoned professionals, leverage state‑of‑the‑art technology, and contribute to a culture that values transparency, continuous improvement, and work‑life balance.

Key Responsibilities

• Eligibility Verification: Conduct thorough eligibility checks for provider claims using brighthush’s proprietary tools and external data sources.
• Data Management: Update, reconcile, and maintain provider and claim records in our Electronic Health Record (EHR) system, ensuring 100% data integrity.
• Discrepancy Resolution: Identify, investigate, and resolve claim discrepancies, working closely with providers, payers, and internal teams to achieve timely resolutions.
• Customer Support: Serve as the first line of communication for providers and internal stakeholders, delivering professional, courteous, and timely assistance.
• Process Improvement: Participate in continuous improvement initiatives, providing feedback on workflow enhancements and automation opportunities.
• Compliance & Documentation: Adhere to all regulatory requirements and company policies, maintaining meticulous documentation for audit readiness.
• Reporting: Generate and analyze daily, weekly, and monthly reports on claim status, turnaround times, and quality metrics.

Essential Qualifications

• 1–2 years of experience in a healthcare call center, medical billing, or administrative role.
• Strong understanding of insurance terminology, provider networks, and claims processing workflows.
• Proficiency with Electronic Health Record (EHR) systems and Microsoft Excel (advanced functions, pivot tables, and data analysis).
• Excellent written and verbal communication skills in English, with a professional tone and attention to detail.
• Ability to work independently in a remote setting, managing time effectively and meeting performance metrics.
• Background check clearance and a clean record.

Preferred Qualifications

• Experience with claims management software such as Epic, Cerner, or Meditech.
• Knowledge of HIPAA regulations and data privacy best practices.
• Prior exposure to provider credentialing or medical coding (ICD‑10, CPT).
• Demonstrated ability to handle high call volumes while maintaining accuracy.
• Fluency in additional languages (Spanish, French, etc.) is a plus.

Skills & Competencies

• Analytical Thinking: Ability to dissect complex claim data and identify root causes of discrepancies.
• Customer‑Centric Mindset: Passion for delivering exceptional service and building lasting relationships with providers.
• Technical Proficiency: Comfortable navigating multiple software platforms, troubleshooting issues, and learning new tools quickly.
• Collaboration: Works effectively with cross‑functional teams, including billing, compliance, and IT.
• Adaptability: Thrives in a dynamic environment where priorities shift and new challenges arise.
• Attention to Detail: Maintains high accuracy in data entry, documentation, and quality checks.

Career Growth & Learning Opportunities

At brighthush, your career trajectory is designed to be as dynamic as the healthcare industry itself. Starting as a Provider Claims Customer Service Specialist, you’ll have the opportunity to:

• Advance to a Senior Claims Analyst role, overseeing complex claim investigations and mentoring new hires.
• Transition into a Process Improvement Lead, driving automation initiatives and streamlining workflows across the organization.
• Explore cross‑functional projects in Compliance, Data Analytics, or Product Development, broadening your skill set and industry knowledge.
• Participate in our internal training programs, including certification courses in medical billing, coding, and healthcare IT.
• Attend industry conferences and webinars, staying ahead of emerging trends and regulatory changes.

Work Environment & Company Culture

brighthush embraces a remote‑first philosophy, allowing you to work from the comfort of your home while staying connected through collaborative tools like Slack, Microsoft Teams, and Zoom. Our culture is built on:

• Transparency: Open communication channels and regular town‑hall meetings keep everyone aligned.
• Innovation: We encourage experimentation and reward creative solutions that improve efficiency.
• Inclusivity: A diverse workforce that values different perspectives and promotes equity.
• Well‑Being: Flexible schedules, mental health resources, and virtual wellness programs support your overall health.
• Recognition: Monthly awards, shout‑outs, and performance bonuses celebrate your contributions.

Compensation & Benefits

We offer a competitive salary range of USD 33,280 – 37,440 per year, commensurate with experience and performance. In addition to base pay, you’ll enjoy:

• Health, dental, and vision insurance plans with employer contributions.
• 401(k) retirement plan with company match.
• Paid time off (vacation, sick leave, and holidays) that accrues monthly.
• Professional development stipend for courses, certifications, and conferences.
• Flexible work hours and a fully remote work setup.
• Employee assistance program and mental health resources.
• Annual performance bonus potential based on company and individual metrics.

How to Apply

If you’re ready to join a forward‑thinking organization that values your expertise and invests in your growth, we’d love to hear from you. Click the link below to submit your application and take the first step toward a rewarding career at brighthush.