Seasoned Customer Service Representative II – Remote Healthcare Support Specialist with First‑Call Resolution Expertise & Member Advocacy Champion at brighthush

Welcome to brighthush – Where Compassion Meets Innovation

At brighthush, we’re not just a healthcare technology company; we’re a movement dedicated to reshaping the way families, businesses, and communities experience health coverage. By marrying cutting‑edge digital platforms, predictive analytics, and a relentless focus on customer empathy, we’re redefining what it means to provide health coverage that truly works for everyone. Our mission is simple yet ambitious: to transform the way people navigate the complex world of health insurance into a seamless, transparent, and empowering experience.

Why brighthush? Why This Role?

Our culture thrives on collaboration, continuous learning, and a shared commitment to making a tangible difference in the lives of our members and partners. Whether you’re a seasoned professional or just starting your career, you’ll find a place where your ideas are heard, your growth is supported, and your impact is felt every day. As a Customer Service Representative II (CSR II) working remotely, you will be the frontline advocate for brighthush’s members and providers. Your primary responsibility is to resolve inquiries on the first call, ensuring accuracy, clarity, and compliance with all regulatory standards.

Impactful Work That Shapes Lives

In the healthcare landscape, the first interaction a member has with a support team can shape their entire experience. By mastering first‑call resolution, you help reduce member frustration, improve satisfaction scores, and drive operational efficiency. Your expertise will directly influence brighthush’s reputation for outstanding service and member loyalty.

Key Responsibilities

• First‑Call Resolution: Resolve 80%+ of member inquiries on the first contact, ensuring accurate, compliant, and compassionate responses.
• Member Advocacy: Act as the voice of the member, translating complex policy language into clear, actionable guidance.
• Data Accuracy: Update member records in our CRM with meticulous attention to detail, ensuring data integrity for downstream analytics.
• Compliance & Quality Assurance: Adhere to all regulatory requirements (HIPAA, ACA, etc.) and internal quality standards, participating in regular audits and coaching sessions.
• Cross‑Functional Collaboration: Partner with Claims, Enrollment, and Technical Support teams to resolve escalated issues and streamline member journeys.
• Continuous Improvement: Provide feedback on process gaps, suggest workflow enhancements, and contribute to the development of knowledge base articles.
• Performance Metrics: Meet or exceed key performance indicators (KPIs) such as average handle time, first‑contact resolution, and member satisfaction scores.
• Training & Mentorship: Mentor new hires and share best practices to elevate team performance.

Essential Qualifications

• Minimum of 2–3 years of experience in a high‑volume customer service environment, preferably within healthcare or insurance.
• Strong knowledge of health insurance terminology, benefits administration, and regulatory frameworks.
• Proficiency with CRM systems (e.g., Salesforce, Zendesk) and Microsoft Office Suite.
• Excellent verbal and written communication skills, with the ability to explain complex concepts in simple terms.
• Demonstrated ability to handle high‑stress situations while maintaining composure and professionalism.
• Self‑motivated, detail‑oriented, and capable of working independently in a remote setting.
• Valid U.S. driver’s license and reliable internet connection (minimum 25 Mbps).

Preferred Qualifications

• Experience with telehealth or member portal platforms.
• Knowledge of data analytics tools (e.g., Tableau, Power BI) and ability to interpret member data trends.
• Previous exposure to first‑call resolution metrics and continuous improvement initiatives.
• Multilingual capabilities (Spanish, French, Mandarin, etc.) to serve a diverse member base.
• Certification in Customer Service Excellence or related fields.

Skills & Competencies

• Empathy & Active Listening: Ability to connect with members, understand their concerns, and respond with genuine care.
• Problem‑Solving: Quick analytical thinking to diagnose issues and propose effective solutions.
• Time Management: Prioritize tasks efficiently to meet daily call volume targets without sacrificing quality.
• Adaptability: Thrive in a fast‑moving environment, embracing new technologies and evolving processes.
• Team Collaboration: Work seamlessly with cross‑functional teams, sharing insights and fostering a culture of continuous improvement.
• Technical Proficiency: Comfortable navigating multiple software platforms and troubleshooting basic technical issues.

Career Growth & Learning Opportunities

At brighthush, we believe in nurturing talent and providing clear pathways for advancement. As a CSR II, you will have the opportunity to:

• Progress to a Senior Customer Service Representative role, taking on more complex cases and leadership responsibilities.
• Transition into Team Lead or Managerial positions, guiding a squad of CSRs and shaping service strategies.
• Explore Specialist tracks such as Claims Processing, Enrollment Support, or Technical Support.
• Participate in our Leadership Development Program, designed to cultivate future leaders through mentorship, workshops, and project assignments.
• Access a robust Learning & Development Portal featuring courses on healthcare policy, data analytics, and customer experience excellence.

Work Environment & Company Culture

brighthush champions a culture of inclusivity, innovation, and impact. Our remote‑first model empowers you to work from anywhere while staying connected through:

• Weekly virtual town halls and team check‑ins.
• Monthly hackathons and innovation challenges.
• Wellness programs, including virtual fitness classes and mental health resources.
• Annual retreats that blend team building with community service projects.
• A transparent feedback loop where your voice shapes policies and processes.

Compensation, Perks, & Benefits

While specific figures vary by role and location, brighthush offers a competitive compensation package that includes:

• Base salary commensurate with experience and market benchmarks.
• Performance‑based bonuses tied to first‑call resolution and member satisfaction metrics.
• Comprehensive health, dental, and vision insurance plans.
• 401(k) retirement plan with company match.
• Generous paid time off (PTO) and flexible holiday scheduling.
• Remote work stipend to support home office setup.
• Access to a digital learning library and tuition reimbursement for relevant certifications.
• Employee referral bonuses and wellness incentives.

How to Apply

Ready to make a real difference in the lives of millions of members? Click the link below to submit your application and join the brighthush family:

Apply for this job

Join brighthush Today

At brighthush, your work goes beyond answering questions—it shapes the future of healthcare for families and businesses across the nation. If you’re a seasoned customer service professional with a passion for first‑call resolution, empathy, and continuous improvement, we want to hear from you. Apply now and become a pivotal part of a mission‑driven team that values innovation, collaboration, and the well‑being of our members.