Seasoned Remote Customer Service Specialist – Healthcare Claims & Member Support Champion (High‑Volume, HIPAA‑Compliant, AI‑Enabled) – Lead Digital Health Innovation at brighthush

About brighthush

brighthush is a trailblazer in the digital health arena, fusing cutting‑edge technology with a deeply human touch. We empower members, providers, and payers to navigate the intricate healthcare ecosystem with confidence, clarity, and compassion. By leveraging artificial intelligence, predictive analytics, and a culture of continuous learning, we deliver solutions that are not only efficient but also profoundly personalized. Recognized as a top workplace for employee growth, diversity, and community impact, brighthush offers a vibrant environment where seasoned veterans and emerging talent alike thrive, innovate, and make a lasting difference in the lives of millions.

Why brighthush?

At brighthush, we believe the best solutions come from the people who use them. That’s why we invest heavily in:

• Employee well‑being: mental health resources, mindfulness sessions, and fitness challenges.
• Professional development: tuition assistance, internal mentorship, and a robust learning portal.
• Inclusive culture: open dialogue, diversity initiatives, and a zero‑tolerance policy for bias.
• Impact: every call you handle directly improves member experience and supports provider success.

Our remote‑first model gives you the flexibility to work from anywhere while staying connected to a vibrant, collaborative community.

Role Overview

As a Remote Customer Service Specialist at brighthush, you will be the frontline champion for our members and providers. You’ll handle high‑volume inbound and outbound calls, resolve inquiries with first‑call accuracy, and ensure that every interaction reflects our core values of empathy, integrity, and excellence. This full‑time, remote position offers flexibility, a competitive pay package, and a wealth of professional development opportunities.

In this role, you’ll become an expert in our claims system, provider portal, and member communication tools. You’ll collaborate with cross‑functional teams to troubleshoot issues, improve processes, and drive customer satisfaction metrics.

Key Responsibilities

• Deliver outstanding customer service via phone, email, and chat, ensuring first‑call resolution whenever possible.
• Conduct thorough research to provide accurate claims status, policy details, and procedural guidance.
• Escalate complex issues to the appropriate departments while maintaining clear documentation of all interactions.
• Maintain strict compliance with Personal Protected Information (PPI) and HIPAA regulations.
• Track performance metrics, meet or exceed quality standards, and participate in continuous improvement initiatives.
• Collaborate with cross‑functional teams—including Claims, Provider Services, and IT—to resolve member and provider concerns.
• Utilize brighthush’s AI‑powered virtual agent to access real‑time guidance and streamline workflow.
• Participate in ongoing training and professional development programs to stay current on industry best practices.
• Contribute to a culture of teamwork, knowledge sharing, and continuous learning.
• Act as a brand ambassador, embodying brighthush’s values in every interaction.
• Assist in the creation and refinement of knowledge base articles, FAQs, and training materials.
• Monitor and report on emerging trends in member inquiries to inform product and process enhancements.
• Support the implementation of new features and tools by providing frontline feedback and user insights.
• Participate in quarterly quality reviews and audit processes to ensure compliance and excellence.

Essential Qualifications

• High School Diploma or GED (required).
• Minimum of 2 years of customer service experience in a high‑volume environment.
• Proficiency with Microsoft Office Suite and the ability to navigate multiple systems simultaneously.
• Strong verbal and written communication skills, with the ability to adapt tone for diverse audiences.
• Demonstrated ability to de‑escalate conflict, handle sensitive information, and maintain composure under pressure.
• Reliable internet connection, a quiet workspace, and a dedicated phone line.
• Availability to work flexible shifts, including evenings and weekends, as needed.
• Basic understanding of healthcare terminology and insurance concepts is a plus.
• Experience using CRM or help‑desk software.

Preferred Qualifications

• Experience in healthcare, insurance, benefits, or claims processing.
• Background in call center operations with high‑volume inbound/outbound calls.
• Knowledge of HIPAA regulations and PPI handling.
• Prior exposure to AI‑powered virtual agents or knowledge‑management platforms.
• College coursework or a degree in a related field.
• Experience with performance metrics, audits, and quality assurance processes.
• Familiarity with data analytics tools.

Skills & Competencies

• Customer‑centric mindset with a passion for problem solving.
• Exceptional multitasking and time‑management abilities.
• Analytical thinking and attention to detail.
• Strong teamwork and collaboration skills.
• Adaptability to new technologies and evolving processes.
• Commitment to continuous learning and self‑improvement.
• Proactive communication and the ability to influence stakeholders.
• Resilience and the capacity to thrive in a fast‑paced environment.

Career Growth & Learning Opportunities

At brighthush, we believe in nurturing talent from the ground up. As a Customer Service Specialist, you’ll have clear pathways to advance into:

• Senior Customer Service Representative
• Team Lead or Supervisor roles
• Specialist positions in Claims, Provider Relations, or Compliance
• Project Management or Process Improvement teams
• Product Management or Customer Experience Leadership

We offer tuition assistance for undergraduate and graduate coursework, access to internal mentorship programs, and a robust learning platform that includes webinars, certifications, and on‑the‑job training. Nearly 70% of promotions within our Operations division originate from the Customer Service team, underscoring the potential for rapid career advancement.

In addition, you’ll have the opportunity to:

• Lead cross‑functional projects that shape the future of our platform.
• Earn industry certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Customer Experience Professional (CCXP).
• Participate in hackathons and innovation challenges to prototype new solutions.
• Attend annual conferences and workshops to stay ahead of industry trends.

Work Environment & Culture

Working remotely from the comfort of your home, you’ll still feel the brighthush community through:

• Virtual team huddles and social events
• Monthly town‑hall meetings with leadership
• Peer‑to‑peer recognition through the RISE program
• Access to a digital wellness portal with mental health resources, mindfulness sessions, and fitness challenges
• Annual in‑person retreats and regional meet‑ups for networking and team building
• Flexible work schedule with a 5‑a‑m to 8‑p.m. Pacific Time window
• One‑time pre‑tax home office stipend of $500 upon successful completion of training

Our culture is built on transparency, respect, and a shared commitment to improving lives. We celebrate diversity, encourage open dialogue, and empower employees to bring their authentic selves to work. Every team member is encouraged to contribute ideas, challenge the status quo, and drive continuous improvement.

Compensation & Benefits

We offer a competitive salary range of $38,500 – $57,800 per year, with potential for performance‑based increases. In addition to a comprehensive benefits package, you’ll receive:

• Health, vision, and dental coverage starting on day one
• Employer‑matched 401(k) and a vested pension plan after 3 years
• Paid time off: 8 days per year plus two floating holidays, plus additional PTO for seniority
• Flexible work schedule with a 5‑a‑m to 8‑p.m. Pacific Time window
• One‑time pre‑tax home office stipend of $500 upon successful completion of training
• Tuition assistance for undergraduate and graduate studies
• Employee wellness incentives, including counseling services, stress‑management programs, and mindfulness resources
• Pet insurance options for animal lovers
• Recognition rewards through the RISE program, redeemable for gift cards, experiences, or charitable donations
• Access to a digital library of industry publications and research reports
• Annual performance bonus pool based on company and individual metrics

How to Apply

If you’re ready to join a forward‑thinking organization that values your expertise, empathy, and drive to make a difference, we’d love to hear from you. Click the link below to submit your application and take the first step toward a rewarding career at brighthush.