Senior Bilingual Claims Customer Service Specialist – Remote Florida – Claims Adjudication, Customer Support, Process Improvement, Data‑Driven Decision Making, and Continuous Improvement Champion

About brighthush

brighthush is a forward‑thinking consulting powerhouse that empowers businesses to master the ever‑shifting claims landscape with confidence, clarity, and a relentless customer‑first mindset. With a reputation for excellence in claims management and frontline service, we blend innovation, collaboration, and continuous growth to deliver solutions that matter. Our remote‑first culture gives talented professionals across Florida the flexibility to work where they thrive while staying connected to a vibrant, high‑performing team.

Why brighthush is the Place to Grow Your Career

At brighthush, we believe that the best results come from people who feel heard, valued, and supported. That’s why we invest heavily in:

• Competitive base salaries that reflect market standards and your experience.
• Performance‑based bonuses that reward individual and team achievements.
• Comprehensive health, dental, and vision plans with low employee contributions.
• 401(k) retirement savings with a generous company match.
• Generous paid time off, holidays, and a flexible work schedule that respects your life outside of work.
• Remote work stipend and ergonomic support to create a home office that feels like a second workplace.
• Ongoing training, mentorship, and access to industry certifications that keep you ahead of the curve.
• Employee recognition programs, wellness initiatives, and community outreach that foster a sense of belonging.

Industry Landscape & Our Role

The claims industry is evolving at a rapid pace, driven by technology, regulatory change, and shifting customer expectations. Companies need skilled professionals who can navigate complex policies, leverage data, and deliver exceptional service while maintaining compliance. At brighthush, we sit at the intersection of technology and human expertise, providing end‑to‑end claims solutions that help our clients reduce risk, improve customer satisfaction, and increase operational efficiency.

Key Responsibilities

As a Senior Bilingual Claims Customer Service Specialist, you will be the frontline advocate for our clients, ensuring that every claim is handled with precision, empathy, and efficiency. Your day‑to‑day tasks will include:

• Claims Adjudication: Thoroughly review claim documentation, verify coverage, and determine claim validity in accordance with company policies and regulatory requirements.
• Customer Support: Serve as the primary point of contact for claimants, answering inquiries, providing status updates, and resolving issues in a timely and professional manner.
• Documentation & Record‑Keeping: Accurately log all claim activities in our CRM system, ensuring data integrity and compliance with internal audit standards.
• Cross‑Functional Collaboration: Work closely with adjusters, legal teams, and vendors to gather necessary information and expedite claim resolution.
• Process Improvement: Identify opportunities to streamline workflows, reduce cycle times, and enhance the overall customer experience.
• Regulatory & Policy Updates: Stay current on state and federal claims regulations, as well as internal policy changes, and communicate relevant updates to the team.
• Training & Knowledge Sharing: Participate in regular training sessions and knowledge‑sharing workshops to stay ahead of industry trends and best practices.
• Data Analysis & Reporting: Generate weekly and monthly reports on claim metrics, identify trends, and provide actionable insights to leadership.
• Quality Assurance: Conduct periodic audits of claim files to ensure compliance with quality standards and identify areas for improvement.
• Mentorship: Coach and support junior team members, fostering a culture of continuous learning and high performance.

Essential Qualifications

• High school diploma or GED (college coursework or degree preferred).
• Minimum of 2 years of call center or customer service experience, preferably in a claims or insurance environment.
• Fluency in both English and Spanish (written and spoken).
• Typing speed of 25–30 words per minute with high accuracy.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).
• Strong communication skills, both verbal and written.
• Excellent problem‑solving abilities and a keen eye for detail.
• Self‑motivated, organized, and able to manage multiple priorities in a fast‑paced environment.

Preferred Qualifications

• Experience with claims management software (e.g., brighthush, brighthush).
• Background in insurance, risk management, or related fields.
• Knowledge of state and federal claims regulations.
• Previous remote work experience with strong time‑management skills.
• Certification in Customer Service Excellence or related professional development.

Key Skills & Competencies

• Customer‑Centric Mindset: Demonstrated ability to empathize with clients and deliver solutions that exceed expectations.
• Analytical Thinking: Ability to interpret data, identify trends, and make informed decisions.
• Technical Proficiency: Comfortable navigating multiple software platforms and quickly learning new tools.
• Collaboration: Works effectively with cross‑functional teams, fostering open communication and shared success.
• Adaptability: Thrives in a dynamic environment, adjusting to changing priorities and evolving processes.
• Time Management: Prioritizes tasks efficiently, meeting deadlines while maintaining high quality.
• Resilience: Handles challenging situations with composure and a solutions‑oriented attitude.

Career Growth & Development

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

• Senior Claims Specialist – leading complex claim investigations and mentoring junior staff.
• Claims Analyst – analyzing claim data to inform strategic decisions and process improvements.
• Claims Manager – overseeing a team of specialists, setting performance goals, and driving operational excellence.
• Consulting Roles – leveraging your claims expertise to advise clients on risk mitigation and policy optimization.

We support your growth through:

• Structured onboarding and continuous learning modules.
• Mentorship programs pairing you with experienced leaders.
• Access to industry conferences, webinars, and certification courses.
• Regular performance reviews with actionable feedback and career planning.

Work Environment & Culture

brighthush’s remote work model is designed to give you the freedom to balance professional and personal commitments. Our culture is characterized by:

• Weekly virtual team huddles to align on goals and celebrate wins.
• Open‑door communication channels with leadership and peers.
• Inclusive hiring practices that celebrate diversity and foster belonging.
• Employee resource groups focused on professional development, wellness, and community outreach.
• Regular virtual social events, such as trivia nights and wellness challenges.

Compensation & Benefits

While specific figures are tailored to experience and location, you can expect:

• Competitive base salary commensurate with industry standards.
• Performance‑based bonuses tied to individual and team metrics.
• Health, dental, and vision coverage with a low employee contribution.
• 401(k) plan with a generous company match.
• Paid time off, sick leave, and paid holidays.
• Flexible work hours and a fully remote work setup.
• Professional development stipend and access to e‑learning platforms.
• Wellness initiatives, including mental health resources and fitness reimbursements.

How to Apply

Ready to take the next step in your career? Join brighthush and become part of a team that values innovation, integrity, and impact. Click the link below to submit your application and start your journey with us.

Apply to this role at brighthush

Closing Statement

At brighthush, we’re not just filling a position – we’re building a community of dedicated professionals who are passionate about delivering exceptional service and driving meaningful change. If you’re a bilingual, customer‑focused individual with a knack for problem‑solving and a desire to grow within a supportive, remote‑friendly environment, we want to hear from you. Apply today and help shape the future of claims management with brighthush.