Seasoned Pharmacy Customer Service Representative – Remote Healthcare Support Specialist for Prescription Benefit & Claims Resolution

About brighthush

brighthush is a forward‑thinking, technology‑driven healthcare partner that empowers patients, providers, and pharmacies to navigate the complex world of prescription benefits with confidence and clarity. With a mission to simplify medication access and improve health outcomes, brighthush leverages cutting‑edge data analytics, AI‑enhanced workflows, and a customer‑centric culture to deliver seamless support across the entire pharmacy value chain. Whether you’re a member trying to fill a prescription, a pharmacy seeking claim resolution, or a provider coordinating care, brighthush is the trusted ally that keeps the conversation moving forward.

Role Overview

We are seeking a highly motivated, detail‑oriented Pharmacy Customer Service Representative to join our fully remote team. In this role, you will serve as the frontline advocate for members, providers, pharmacies, brokers, and internal stakeholders, addressing a wide range of pharmacy benefit and prescription drug coverage inquiries. Your expertise will help ensure that medication access is timely, accurate, and compliant with all regulatory requirements.

Key highlights of the position:

• Fully remote, EST‑time‑zone based role with approved states: Florida, Georgia, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina, Texas.
• Contract position with competitive hourly compensation ($19.00–$20.00/hr) and a comprehensive benefits package for eligible employees.
• Opportunity to work with a high‑volume, high‑impact call center that serves thousands of members and providers across the United States.
• Collaborative environment that values continuous learning, professional growth, and a culture of empathy and excellence.

Key Responsibilities

As a Pharmacy Customer Service Representative at brighthush, you will:

• Respond promptly to inbound calls and inquiries related to commercial pharmacy benefits, prescription coverage, pharmacy claims, and plan information.
• Provide clear, accurate guidance to members who are actively trying to fill medications, helping them understand coverage details, resolve claim rejections, and identify next steps.
• Assist providers, pharmacies, brokers, and internal teams with pharmacy‑related questions, ensuring a smooth flow of information and timely issue resolution.
• Research and resolve inquiries using internal systems, routing queues, vendor applications, plan documents, and knowledge resources.
• Review and interpret pharmacy benefit information, policies, procedures, and plan requirements to deliver precise, compliant guidance.
• Document all interactions thoroughly and accurately in accordance with HIPAA, organizational, plan, and regulatory standards.
• Escalate complex issues when necessary and coordinate with internal teams or vendor contacts to achieve resolution.
• Maintain compliance with HIPAA, organizational, plan, and regulatory requirements at all times.
• Meet or exceed quality, productivity, and customer experience metrics in a structured, monitored environment.
• Participate in ongoing training and coaching to stay current on commercial pharmacy benefits, plan requirements, and internal processes.

Essential Qualifications

To thrive in this role, you should possess:

• High School Diploma or GED (or equivalent).
• 2–3 years of healthcare call center or customer service experience, or medical scheduling experience.
• Strong verbal and written communication skills, with the ability to explain complex information clearly and professionally.
• Exceptional attention to detail and accuracy in documentation and data entry.
• Comfortable navigating multiple systems simultaneously while assisting callers.
• Ability to work independently and as part of a collaborative team.
• Reliable attendance and the capacity to thrive in a structured, performance‑driven environment.

Preferred Qualifications

We value additional experience that aligns with our mission:

• Healthcare call‑center or health‑plan member‑services experience.
• Commercial health‑insurance or pharmacy‑benefit experience.
• Experience with PBM, prescription‑coverage, pharmacy‑claims, or prior‑authorization processes.
• Claims, benefits, insurance, or member‑services experience.
• Background as a pharmacy technician or in pharmacy‑support roles.
• Knowledge of insurance verification or authorizations.

Skills & Competencies

Success in this role requires a blend of technical and soft skills:

• Customer‑centric mindset with a passion for problem‑solving.
• Strong analytical skills to interpret policy documents and claim data.
• Proficiency in CRM and call‑center platforms (e.g., Salesforce, NICE, Genesys).
• Excellent time‑management and multitasking abilities.
• Adaptability to evolving processes, technology, and regulatory changes.
• Team collaboration and knowledge sharing.
• Commitment to maintaining confidentiality and compliance with HIPAA.

Career Growth & Learning Opportunities

At brighthush, we believe in investing in our people. As a Pharmacy Customer Service Representative, you will have access to:

• Structured onboarding and continuous training programs covering pharmacy benefits, claims processing, and regulatory compliance.
• Mentorship from senior customer‑service leaders and subject‑matter experts.
• Cross‑functional exposure to pharmacy operations, analytics, and product development teams.
• Clear career pathways to roles such as Pharmacy Claims Analyst, Member Services Manager, or Operations Lead.
• Regular performance reviews and goal‑setting sessions to align your growth with brighthush’s strategic objectives.
• Access to industry conferences, webinars, and certification courses (e.g., Certified Pharmacy Technician, Health Insurance Associate).

Work Environment & Company Culture

brighthush fosters a culture of inclusivity, innovation, and empowerment. Our remote team enjoys:

• Flexible scheduling within the EST time zone to accommodate personal commitments.
• Regular virtual team‑building events, knowledge‑sharing sessions, and wellness initiatives.
• A collaborative environment where every voice is heard and valued.
• Transparent communication from leadership, with a focus on data‑driven decision‑making.
• Commitment to diversity, equity, and inclusion, ensuring a welcoming space for all employees.

Compensation & Benefits

While this is a contract position, eligible employees may receive a competitive hourly rate of $19.00–$20.00, with compensation adjusted based on qualifications, experience, and geographic location. In addition to base pay, brighthush offers a robust benefits package for eligible employees, including:

• Medical, dental, and vision coverage.
• Critical illness, accident, and hospital plans.
• 401(k) retirement plan with pre‑tax and Roth contributions.
• Life insurance (voluntary life & AD&D for employee and dependents).
• Short‑ and long‑term disability coverage.
• Health Spending Account (HSA).
• Transportation benefits.
• Employee Assistance Program (EAP).
• Paid time off (PTO), vacation, and sick leave.

All benefits are subject to eligibility criteria and may vary based on employment classification and length of service.

How to Apply

Ready to make a meaningful impact on medication access and patient care? Submit your application through the brighthush careers portal. We review applications on a rolling basis and will contact qualified candidates for next steps. The application deadline is October 29, 2026.

Closing

At brighthush, you’ll join a dedicated team that is reshaping the pharmacy benefit landscape. Your expertise will directly influence how members, providers, and pharmacies experience the healthcare system—ensuring that medication access is timely, accurate, and compliant. If you are passionate about customer service, thrive in a fast‑paced environment, and are eager to grow your career in healthcare support, we encourage you to apply today. Together, we can bring clarity, compassion, and confidence to every prescription journey.