Seasoned Remote Customer Service Advocate – Claims & Benefits Specialist – Full‑Time, 27‑State Eligibility – Join brighthush’s Mission‑Driven Team

About brighthush

brighthush is a trailblazing not‑for‑profit health‑insurance provider that has redefined how compassionate care meets cutting‑edge technology. With a legacy rooted in community‑first values and a forward‑thinking approach to wellness, brighthush empowers its workforce to make a tangible difference in the lives of millions of members across the United States. Our mission is simple yet powerful: to deliver reliable, affordable coverage while fostering a culture of collaboration, continuous learning, and personal growth. As we expand our reach, we’re looking for passionate individuals who share our commitment to innovation and service excellence.

Why Join brighthush?

At brighthush, you’ll be part of a purpose‑driven organization that treats every member as a partner in health. We celebrate diversity, champion transparency, and encourage every employee to bring their authentic self to work. Whether you’re a seasoned professional or an ambitious newcomer, you’ll find a supportive environment that rewards initiative, rewards curiosity, and rewards results. Our remote‑first model gives you the flexibility to work from any of the 27 eligible states while staying connected to a vibrant virtual community.

Position Overview

As a Customer Service Advocate – Claims & Benefits Specialist, you will serve as the frontline champion for our members, ensuring they receive timely, accurate information and support throughout their insurance journey. This remote, full‑time role offers the flexibility to work from any of the 27 eligible states while being part of a dynamic, high‑performing team that values innovation, empathy, and excellence. You will collaborate with cross‑functional partners, leverage enterprise systems, and continuously seek ways to enhance the member experience.

Key Responsibilities

• Resolve Customer Inquiries: Handle a high volume of member calls, emails, and chat requests, providing clear, concise, and accurate responses regarding coverage, benefits, and claims status. Use active listening and empathy to build trust and ensure satisfaction.
• Educate Members: Deliver educational sessions and resources that help members understand their plans, eligibility, and the claims process. Create user‑friendly guides, FAQs, and video tutorials to empower members to navigate their benefits independently.
• Support Complex Claims: Investigate and resolve intricate claims issues, collaborating with internal stakeholders and external partners to expedite resolution and maintain compliance with regulatory standards. Document root causes and recommend process improvements.
• Maintain Accurate Records: Log all interactions in the Facets system, ensuring data integrity, audit readiness, and adherence to privacy regulations such as HIPAA. Perform regular data quality checks and reconcile discrepancies.
• Continuous Improvement: Identify trends, propose process enhancements, and participate in cross‑functional projects aimed at improving member experience and operational efficiency. Present findings to leadership and track implementation outcomes.
• Team Collaboration: Attend virtual huddles, training sessions, and knowledge‑sharing meetings to stay current on product updates, policy changes, and best practices. Mentor junior team members and contribute to a culture of shared learning.

Essential Qualifications

• Education: High school diploma or GED equivalent. A bachelor’s degree in Business, Healthcare Administration, or a related field is a plus and demonstrates a strong foundation in analytical thinking and communication.
• Experience: Minimum of 3 years in a customer‑service or claims environment, preferably within the health‑insurance or related industry. Experience handling high‑volume inquiries and complex claims is highly valued.
• Technical Proficiency: Demonstrated ability to navigate enterprise systems such as Facets; familiarity with IPP (Integrated Provider Portal) is highly desirable. Comfortable troubleshooting software issues and learning new tools quickly.
• Communication Skills: Exceptional verbal and written communication skills in English, with the ability to convey complex information in a member‑friendly manner. Strong active listening and conflict‑resolution skills are essential.
• Problem‑Solving: Strong analytical mindset, capable of troubleshooting issues, identifying root causes, and implementing effective solutions. Ability to think critically under pressure and adapt to changing priorities.
• Compliance Awareness: Knowledge of HIPAA, ACA, and other relevant regulatory frameworks governing member data and claims processing. Commitment to maintaining confidentiality and data security.

Preferred Qualifications

• Facets Expertise: Advanced proficiency in Facets, including claims entry, status tracking, and reporting. Experience creating dashboards and generating actionable insights.
• IPP Experience: Hands‑on experience with the Integrated Provider Portal, enabling seamless coordination with healthcare providers and third‑party vendors.
• Multilingual Abilities: Fluency in Spanish or another language is an asset, allowing you to serve a broader member base and enhance inclusivity.
• Leadership Potential: Demonstrated ability to mentor junior staff or lead small project teams. Strong interpersonal skills and a collaborative mindset.

Skills & Competencies

• Customer‑centric mindset with a passion for service excellence.
• Strong organizational skills and meticulous attention to detail.
• Adaptability to changing priorities and fast‑paced environments.
• Team player who thrives in virtual collaboration settings.
• Proactive learner eager to stay updated on industry trends and product innovations.
• Data‑driven decision maker with a knack for turning insights into action.
• Resilience and emotional intelligence to handle challenging member interactions.

Career Growth & Learning Opportunities

At brighthush, we believe in investing in our people. As a Customer Service Advocate, you will have access to a comprehensive learning portal featuring courses on claims processing, regulatory compliance, and advanced customer‑experience strategies. Our internal career ladder offers clear pathways to roles such as Senior Claims Analyst, Team Lead, or Managerial positions in Operations or Member Services. Mentorship programs, quarterly skill‑building workshops, and cross‑departmental shadowing opportunities ensure you continuously grow professionally and personally. Whether you aspire to deepen your expertise in claims analytics or transition into leadership, brighthush provides the resources, support, and recognition to help you succeed.

Work Environment & Company Culture

brighthush fosters a culture of inclusion, transparency, and innovation. Even though this role is remote, you will be fully integrated into our virtual community through weekly team meetings, monthly town halls, and informal virtual coffee breaks. We celebrate diversity, encourage open dialogue, and empower employees to bring their authentic selves to work. Our flexible scheduling model supports work‑life balance, allowing you to manage your responsibilities while staying connected with colleagues across the country. We also host quarterly virtual retreats and community service initiatives that bring our remote workforce together around shared values and purpose.

Compensation & Benefits

Salary Range: $41,600 – $66,561 per year, commensurate with experience and qualifications.

Benefits Package:

• 401(k) plan with company matching to help you build a secure financial future.
• Generous paid time off (PTO) policy, including vacation, sick leave, and personal days.
• Health, dental, and vision insurance plans with competitive premiums.
• Wellness stipend for gym memberships, mental‑health resources, and wellness apps.
• Employee assistance program (EAP) for confidential counseling and support.
• Professional development stipend and tuition reimbursement for relevant certifications.
• Flexible work‑from‑home stipend to support your home‑office setup.
• Access to a digital library of industry publications, webinars, and conferences.

Eligibility & Work Location

This remote position is open to candidates residing in any of the following states: North Carolina, Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, or Wyoming. Applicants must be legally authorized to work in the United States and possess a reliable internet connection and a suitable home‑office setup. A quiet, dedicated workspace and a headset with a noise‑cancelling microphone are required for optimal performance.

How to Apply

If you are passionate about delivering exceptional member service, thrive in a collaborative remote environment, and are ready to grow your career with a purpose‑driven organization, we encourage you to apply today. Submit your resume and a brief cover letter outlining your relevant experience and why you would be an excellent fit for brighthush. We look forward to welcoming you to our team and working together to make a lasting impact on the lives of our members.