Seasoned Healthcare Provider Services Advocate – Remote Claims, Appeals & Payment Support Specialist

About brighthush

brighthush is a technology‑driven healthcare operations partner that has been delivering world‑class service solutions for over 25 years. With a global footprint that spans 10 secure facilities across the United States and a dedicated hub in Manila, Philippines, brighthush empowers health plans, payers, and providers to streamline complex administrative processes. Our mission is to drive efficiency, accuracy, and transparency across the entire healthcare value chain, from digital mailroom and claims adjudication to member communications and provider support. By combining seasoned operational teams, proven workflows, and purpose‑built technology, brighthush ensures that essential processes move smoothly for the members, providers, and communities we serve.

Why Join brighthush?

At brighthush, we believe that our people are our greatest asset. We foster a culture of collaboration, continuous learning, and innovation, where every team member is empowered to make an impact. As a remote‑first organization, we offer the flexibility to work from anywhere while maintaining a strong sense of community through virtual town halls, mentorship programs, and cross‑functional projects. If you’re passionate about improving healthcare outcomes, thrive in a fast‑paced environment, and want to grow your career with a forward‑thinking partner, brighthush is the place for you.

Job Summary

We are urgently hiring a dedicated Healthcare Provider Services Advocate to serve as the primary point of contact for healthcare providers and billing agencies. In this role, you will manage a high volume of inquiries related to claims, appeals, and payment concerns via email, fax, and web channels. Your mission is to resolve provider issues efficiently, maintain compliance with HIPAA and company policies, and uphold the highest standards of customer service. This position is remote, but you may be required to report to our Manila office for periodic team meetings or performance reviews.

Key Responsibilities

• Act as the first line of support for providers and billing agencies, addressing inquiries about claim status, payments, appeals, and EOBs.
• Respond to multi‑channel requests—phone, email, fax, and web—ensuring timely and accurate communication.
• Research and verify claim information, outcomes, and payment status using internal systems and external resources.
• Coordinate with internal teams (claims, finance, compliance) to investigate and resolve complex provider issues.
• Provide updates on appeals, request additional documentation, and track the progress of each case.
• Handle payment‑related requests such as stop payments, check reissuance, payment tracers, and copies of cashed checks.
• Process requests for upheld and late submission letters in accordance with company guidelines.
• Escalate unresolved or high‑priority issues through the appropriate escalation path.
• Document all interactions accurately in the CRM and maintain complete records for audit purposes.
• Ensure strict compliance with HIPAA, company policies, and confidentiality standards.
• Consistently meet or exceed service level agreements (SLAs), quality metrics, productivity targets, and customer satisfaction goals.
• Deliver professional, courteous, and solution‑oriented service in every interaction.

Essential Qualifications

• High school diploma or equivalent; a college degree is a plus.
• Minimum of 4 years’ experience in a healthcare contact center, provider services, or claims support environment.
• Basic understanding of healthcare claims, EOBs, appeals, and payment processes.
• Strong analytical, multitasking, organizational, and communication skills with meticulous attention to detail.
• Proficiency in Microsoft Office and experience navigating online systems and databases.
• Ability to work flexible shifts, including nights, weekends, and holidays.
• Preferred: Residency in or near Manila.
• Immediate availability to start; this is an urgent hiring.

Preferred Qualifications

• Experience with claims adjudication software or provider portal systems.
• Knowledge of HIPAA regulations and data privacy best practices.
• Previous exposure to remote work environments and self‑management.
• Fluency in English and Filipino (both written and spoken).
• Certifications in customer service, healthcare administration, or related fields.

Key Skills & Competencies

• Customer‑centric mindset with a passion for problem solving.
• Excellent verbal and written communication skills.
• Strong technical aptitude and quick learning ability.
• Proactive approach to identifying process improvements.
• Resilience under pressure and ability to maintain composure during high‑volume periods.
• Team player who collaborates effectively across departments.
• Commitment to continuous learning and professional development.

Career Growth & Learning Opportunities

At brighthush, we invest heavily in the growth of our employees. As a Provider Services Advocate, you will have access to a range of learning resources, including:

• Structured onboarding and mentorship programs to accelerate your integration.
• Regular training sessions on new technologies, industry regulations, and best practices.
• Clear career pathways that can lead to roles in operations management, process improvement, or technology implementation.
• Opportunities to participate in cross‑functional projects that span the entire healthcare ecosystem.
• Recognition programs that celebrate achievements and milestones.

Work Environment & Company Culture

brighthush is a remote‑first organization that values flexibility, collaboration, and innovation. Our culture is built on:

• Open communication channels—weekly virtual stand‑ups, monthly town halls, and instant messaging.
• A supportive team that celebrates successes and learns from challenges.
• Commitment to work‑life balance, with flexible scheduling and generous time‑off policies.
• Emphasis on data‑driven decision making and continuous improvement.
• Inclusive environment where diverse perspectives are valued and encouraged.

Compensation, Perks, and Benefits

• Competitive base salary (up to Php 35,000/month) with performance‑based incentives.
• 13th month salary and annual performance bonus.
• Comprehensive HMO coverage for medical, dental, and vision care.
• Fully equipped remote workstation—monitor, keyboard, headset, and high‑speed internet support.
• Professional development budget and access to industry certifications.
• Flexible work schedule with the option to work from home or the Manila office.
• Regular team building events, virtual coffee chats, and wellness programs.
• Employee recognition program and peer‑to‑peer appreciation platform.

Work‑From‑Home Requirements

• Stable primary internet connection of at least 50 Mbps.
• Reliable backup connection to ensure uninterrupted work.
• Ability to hardwire directly to your modem for optimal performance.
• Dedicated quiet workspace free from distractions.
• Provision of a speed test during the interview process.

Ready to Make an Impact?

If you are a proactive, detail‑oriented professional who thrives in a dynamic environment and is eager to help healthcare providers navigate the complexities of claims and payments, we want to hear from you. Join brighthush and become part of a team that is redefining the future of healthcare operations.

Click the “Apply Now” button below to submit your application and tell us why you would be a valuable addition to our Provider Services team.

About brighthush

brighthush is a technology‑forward healthcare operations partner with more than 25 years of experience helping healthcare payers manage critical administrative and operational processes. Founded in 2000 and headquartered in Tampa, Florida, brighthush supports 150+ health plans through its payer clients. Our teams help improve efficiency, accuracy, visibility, and service across complex healthcare operations, including digital mailroom, claims adjudication, contact center, member communications, and related administrative functions. By combining experienced operational teams, proven processes, and purpose‑built workflow technology, brighthush helps payers keep essential processes moving for the members, providers, and communities they serve.

brighthush operates 10 secure facilities across the U.S. and one secure facility in Manila, Philippines.

Joining brighthush means contributing to work that supports the healthcare operations members and providers rely on every day.