Seasoned Senior Disability Claims Customer Service Lead – Champion of Case Intake, Scheduling & Client Coordination, Driving Data‑Driven Impact & Operational Excellence at brighthush

About brighthush

brighthush stands at the forefront of the disability and workers’ compensation claims arena, redefining how claims are managed across the United States. With a portfolio that spans national carriers, regional insurers, third‑party administrators, managed care organizations, and pharmacy benefit managers, we fuse deep industry expertise, cutting‑edge technology, and an unwavering focus on client success. Our mission is simple yet powerful: to transform the claims experience so that every stakeholder—claimants, carriers, and providers—receives clarity, speed, and compassion.

Every year, brighthush processes more than 200,000 claims, leveraging advanced analytics and proprietary platforms to streamline the entire claims lifecycle. Our culture is built on integrity, collaboration, and a commitment to continuous improvement. We empower our teams to innovate, make data‑driven decisions, and deliver service that exceeds expectations. Whether you’re a seasoned professional or just starting out, brighthush offers a dynamic environment where your contributions matter.

Why brighthush is the Place to Grow Your Career

At brighthush, we believe talent is the engine of innovation. That’s why we invest heavily in our people through structured mentorship programs, learning resources, and clear career pathways. Our high‑performance culture rewards initiative, excellence, and a passion for continuous learning. We celebrate diversity, champion inclusion, and foster an environment where every voice is heard. Whether you’re looking to deepen your expertise in claims processing, expand your leadership skills, or explore new technology initiatives, brighthush provides the support, resources, and opportunities to help you thrive.

Your Role at a Glance

As a Senior Disability Claims Customer Service Lead, you will be the first line of contact for new cases, ensuring accurate intake, meticulous documentation, and efficient scheduling. You will serve as a bridge between clients, physicians, and internal teams, driving operational excellence through data‑driven insights and process optimization. Your leadership will shape the quality of our service, influence team performance, and directly impact client satisfaction.

Key Responsibilities – Your Impact in Action

• Case Intake & Verification – Receive new claims, review submitted information, and verify completeness against client requirements, ensuring every case starts on a solid foundation.
• Data Entry & System Management – Draft cases in our proprietary AccessDS platform, populating all fields accurately and securely while maintaining audit‑ready documentation.
• Client Collaboration – Work closely with clients to gather missing documentation, clarify ambiguities, and maintain open lines of communication, building trust from the first interaction.
• Medical Document Coordination – Compile and organize medical documents into comprehensive listings that align with client specifications, ensuring nothing is overlooked.
• Case Oversight – Monitor case progress, track deadlines, and flag potential bottlenecks to keep the workflow on schedule and prevent delays.
• Assignment & Scheduling – Allocate new cases to appropriate physicians based on location, availability, jurisdictional rules, and conflict‑of‑interest policies, ensuring optimal resource utilization.
• Conflict Management – Verify that assigned reviewers have no conflicts of interest and that all assignments comply with internal guidelines and regulatory requirements.
• Client Updates – Provide regular status updates to clients, ensuring transparency, fostering trust, and reinforcing our commitment to service excellence.
• Documentation Assurance – Confirm that all required documentation is complete and delivered to the client in a timely manner, maintaining the highest standards of accuracy.

Additional Impact Areas

• Process Improvement Initiatives – Identify inefficiencies in intake and scheduling workflows, propose data‑driven solutions, and collaborate with cross‑functional teams to implement best practices.
• Quality Assurance Oversight – Conduct periodic audits of case files to ensure compliance with internal standards and external regulations, providing feedback to the team.
• Training & Mentorship – Lead onboarding sessions for new hires, share knowledge on system usage, and cultivate a culture of continuous learning.
• Stakeholder Engagement – Partner with physicians, adjusters, and legal advisors to resolve complex case issues, ensuring a seamless experience for all parties.

Key Performance Indicators & Success Metrics

Success in this role is measured by a blend of quantitative and qualitative metrics that reflect both operational efficiency and client satisfaction:

• First‑Pass Intake Accuracy – Target of 98% accuracy on initial case entry.
• Turn‑Around Time (TAT) – Average time from claim receipt to first assignment should be under 48 hours.
• Client Satisfaction Score (CSAT) – Maintain a CSAT of 90% or higher across all client interactions.
• Conflict‑of‑Interest Resolution Rate – 100% compliance with conflict checks before assignment.
• Audit Findings – Zero critical audit findings in quarterly quality reviews.

What You'll Bring to the Table

We’re looking for a professional who combines deep industry knowledge with a passion for leadership and continuous improvement. Your background should include:

• Strong experience in disability or workers’ compensation claims, with a proven track record of managing complex case flows.
• Advanced proficiency in CRM and case management systems, with a keen eye for data integrity.
• Exceptional communication skills, both written and verbal, enabling clear, concise, and empathetic interactions with clients and internal stakeholders.
• Demonstrated ability to analyze data, identify gaps, and propose actionable solutions that drive process efficiencies.
• Leadership experience, ideally in a supervisory or team‑lead capacity, with a focus on coaching, performance management, and fostering a high‑performing culture.
• Adaptability to a fast‑paced environment, with the ability to juggle multiple priorities and pivot quickly when needed.

Essential Qualifications – What We Expect

• Education – Associate’s degree preferred; Bachelor’s degree in a related field is a plus.
• Experience – Minimum of 2 years in a healthcare, insurance, or claims processing environment, with a proven track record of managing complex case flows.
• Communication – Excellent verbal and written communication skills; ability to convey complex information clearly to both internal teams and external clients.
• Technical Proficiency – Comfortable with CRM and case management systems; strong typing speed (minimum 45 WPM) and computer literacy across multiple platforms.
• Critical Thinking – Ability to analyze information, identify gaps, and propose solutions quickly, ensuring smooth case progression.
• Time Management – Proven track record of meeting strict deadlines while maintaining high accuracy and attention to detail.
• Attention to Detail – Meticulous approach to data entry and documentation, ensuring every case is error‑free and compliant.

Preferred Qualifications – What Gives You an Edge

• Experience with medical claim adjudication or disability benefits, providing a deeper understanding of the claims ecosystem.
• Knowledge of HIPAA regulations and data privacy best practices, ensuring compliance and confidentiality.
• Familiarity with medical terminology and insurance claim workflows, enabling efficient communication with clinicians and payers.
• Previous exposure to scheduling and conflict‑of‑interest protocols, enhancing your ability to manage complex assignments.

Core Competencies – The Skills That Set You Apart

• Client‑Centric Mindset – Passion for delivering outstanding service and building lasting relationships with clients and stakeholders.
• Collaboration – Works effectively across cross‑functional teams, including physicians, claims adjusters, and legal advisors, to achieve shared goals.
• Adaptability – Thrives in a fast‑paced environment with evolving priorities, quickly adjusting to new processes and technologies.
• Problem‑Solving – Uses analytical skills to resolve issues, streamline processes, and improve overall efficiency.
• Integrity – Upholds confidentiality and ethical standards at all times, maintaining trust with clients and colleagues.

Career Growth & Learning Opportunities – Your Path to Success

At brighthush, we believe in investing in our people. You will have access to:

• Structured onboarding program with mentorship from senior team members, ensuring a smooth transition and rapid skill development.
• Continuous learning through internal workshops, webinars, and industry conferences, keeping you at the forefront of industry trends.
• Clear career ladder with opportunities to advance into senior case management, team lead, or operations roles, allowing you to shape your professional trajectory.
• Cross‑functional projects that broaden your skill set and expose you to new facets of the claims ecosystem, enhancing your versatility and marketability.
• Leadership development initiatives that prepare you for future managerial responsibilities.

Work Environment & Culture – Where Innovation Meets Inclusion

Our office culture is built on transparency, respect, and a shared commitment to excellence. You’ll enjoy:

• Flexible work arrangements, including hybrid and remote options, to support work‑life balance.
• Collaborative team meetings and open forums for idea sharing, fostering a culture of continuous improvement.
• Regular recognition programs that celebrate individual and team achievements, reinforcing a culture of appreciation.
• A supportive environment that encourages personal well‑being, with resources for mental health and wellness.
• Inclusive hiring practices that celebrate diverse perspectives and backgrounds.

Compensation & Benefits – Rewarding Your Expertise

We offer a competitive base salary commensurate with experience, education, and skill set. In addition, you’ll receive:

• Comprehensive health, dental, and vision insurance for you and your family, ensuring you stay protected.
• Voluntary life insurance and critical illness coverage, providing financial security for you and your loved ones.
• Short‑term and long‑term disability protection at no cost, safeguarding your income in the event of unforeseen circumstances.
• Generous paid time off (PTO) and paid holidays, giving you the flexibility to recharge and spend time with family.
• 401(k) retirement plan with company match, helping you build a secure financial future.
• Technology stipend and Apple equipment for remote work, ensuring you have the tools you need to succeed.
• Professional development budget and tuition reimbursement, supporting your ongoing growth and learning.
• Employee assistance program (EAP) and wellness initiatives to promote holistic health.

Our Commitment to Diversity & Inclusion

brighthush is dedicated to creating an inclusive workplace where every employee feels valued and empowered. We actively seek diverse perspectives and provide equal opportunities for growth and advancement, ensuring a vibrant and dynamic team culture that reflects the communities we serve.

Ready to Make an Impact?

If you are a proactive, detail‑oriented professional who thrives in a dynamic environment and Apply for this job