Seasoned Customer Service Representative II – Healthcare Support & Claims Resolution Specialist – Championing Exceptional Member & Provider Experience at brighthush – Join a Leading HealthTech Innovator

Welcome to brighthush – Where Compassion Meets Cutting‑Edge Technology

At brighthush, we’re redefining what it means to provide health coverage in the 21st century. By marrying advanced analytics, AI‑driven tools, and a relentless focus on customer delight, we empower patients, providers, and partners to navigate the complex world of health benefits with confidence and ease. If you thrive in a fast‑paced, purpose‑driven environment and want to make a tangible impact on people’s lives, brighthush is the place for you.

Why This Role Is a Game‑Changer for Your Career

As a Customer Service Representative II (CSR II), you will be the frontline champion of our mission. Your daily interactions will shape member satisfaction, strengthen provider relationships, and elevate the overall quality of care. In return, brighthush offers a comprehensive rewards package, a culture of continuous learning, and a clear path to leadership.

What You’ll Gain

• Competitive base salary aligned with market standards
• Full‑benefit health, vision, and dental coverage starting on day one
• Generous paid time off, floating holidays, and a flexible PTO policy
• Employer‑matched 401(k) and a pension equity plan for long‑term security
• Tuition assistance for undergraduate and graduate studies
• Access to brighthush’s AI‑powered virtual agent for real‑time guidance
• Employee recognition program celebrating milestones and achievements
• Hybrid work model with flexible scheduling and on‑site resources
• Wellness initiatives: virtual fitness classes, mental health support, and on‑site wellness centers

Key Responsibilities – Your Impact Every Day

In this role, you will:

• Handle inbound and outbound customer interactions via phone, email, and chat, striving for first‑contact resolution whenever possible.
• Provide clear, accurate, and timely information regarding claims status, benefits, and policy details.
• Escalate complex issues to the appropriate departments while maintaining a calm and professional demeanor.
• Document all member and provider interactions in our systems with meticulous detail.
• Conduct research across multiple platforms to resolve routine inquiries and gather necessary data.
• Follow up on pending items, route paperwork to the correct departments, and track progress until closure.
• Maintain strict adherence to Personal Protected Information (PPI) and HIPAA compliance standards.
• Participate in ongoing training, including a 12‑week virtual onboarding program, and apply new knowledge to daily tasks.
• Collaborate with cross‑functional teams—claims, provider relations, and compliance—to continuously improve service quality.
• Contribute to process improvement initiatives and share best practices with peers.

Essential Qualifications – What We Expect

• High School Diploma or GED (required).
• Minimum of two years of customer service experience in a high‑volume call center environment.
• Experience in healthcare, insurance, benefits, or claims processing is highly desirable.
• Proficiency with Microsoft Office Suite and the ability to navigate multiple screens and systems simultaneously.
• Strong conflict‑resolution skills, with a proven ability to defuse tense situations and address concerns with empathy and respect.
• Excellent verbal and written communication skills, adaptable to a broad audience.
• Ability to work flexible shifts, including early mornings, evenings, and weekends, as required by quality metrics.
• Demonstrated capacity to accept constructive feedback, adapt work practices, and implement performance improvements.
• Basic understanding of regulatory and compliance requirements related to PPI and HIPAA.

Preferred Qualifications – What Will Set You Apart

• College coursework or three years of work experience in customer service.
• Experience with AI‑powered virtual agents or similar technology platforms.
• Knowledge of provider ecosystems—clinics, hospitals, skilled nursing facilities, and vendors.
• Familiarity with ALICE or other AI‑driven assistance tools.
• Prior exposure to high‑volume metrics and audit processes.
• Experience in a hybrid or remote work environment.

Key Skills & Competencies – The DNA of Success

• Customer‑centric mindset with a passion for service excellence.
• Analytical thinking and problem‑solving abilities.
• Strong organizational skills and attention to detail.
• Team collaboration and cross‑functional communication.
• Adaptability to evolving processes, technologies, and regulatory landscapes.
• Resilience under pressure and a commitment to maintaining high performance standards.
• Proactive learning and continuous improvement orientation.

Career Growth & Development – Your Path to Leadership

At brighthush, we view every CSR II as a potential leader. Nearly 70% of promotions within our Operations division originate from the Customer Service team. By mastering the fundamentals of member and provider support, you’ll open doors to roles such as:

• Senior Customer Service Specialist
• Claims Processing Lead
• Provider Relations Coordinator
• Compliance Analyst
• Operations Manager
• Training & Development Specialist

Our structured learning pathways, mentorship programs, and tuition assistance empower you to acquire new skills, pursue certifications, and advance your career trajectory. Whether you aim to become a subject‑matter expert, a process improvement champion, or a future leader, brighthush provides the resources and support to get you there.

Work Environment & Culture – Thrive in a Purpose‑Driven Team

At brighthush, culture is more than a buzzword—it’s a lived experience. Whether you work from home or our hybrid campus, you’ll enjoy:

• Flexible scheduling that respects work‑life balance.
• Inclusive and supportive teams that celebrate diversity and inclusion.
• Regular team‑building events, wellness activities, and community service opportunities.
• Access to on‑site resources such as cafés, fitness centers, and collaborative workspaces.
• Transparent communication from leadership and a clear path for career advancement.

Compensation & Benefits – Rewarding Your Excellence

Our compensation package is designed to reward performance, support well‑being, and promote long‑term financial security.

• Base Salary: Competitive range of $38,500 to $57,800, depending on location, experience, and market conditions.
• Performance Bonuses: Eligibility for quarterly bonuses tied to individual and team metrics.
• 401(k) Match: Employer match up to 4% of your salary.
• Pension Equity Plan: Vesting after three years of service.
• Health Benefits: Comprehensive medical, vision, and dental coverage with low employee premiums.
• Life & Disability Insurance: Basic coverage with optional supplemental plans.
• Paid Time Off: Generous PTO, 8 paid days off per year, two floating holidays, and flexible PTO policy.
• Tuition Assistance: Up to $5,000 per year for undergraduate and graduate coursework.
• Wellness Incentives: Mental health resources, counseling services, mindfulness programs, and on‑site fitness classes.
• Employee Recognition: brighthush’s RISE program offers rewards, badges, and public acknowledgment for outstanding performance.
• Additional Perks: Pet insurance, commuter benefits, free on‑site parking, and subsidized café access.

How to Apply – Take the First Step Toward a Rewarding Career

Ready to make a difference in the lives of patients and providers? Join brighthush and become part of a team that values innovation, collaboration, and purpose. Click the link below to submit your application and take the first step toward a rewarding career in healthcare customer service.

Apply to brighthush Today