Senior Claims Processing & Customer Experience Specialist – Remote – Driving Employee Benefits Innovation, Claims Excellence, and Client Success at brighthush

About brighthush – Leading the Future of Employee Benefits and Claims Excellence

brighthush is more than a technology platform; it is a movement that reimagines how organizations protect and empower their most valuable asset—people. By blending cutting‑edge artificial intelligence, data‑driven insights, and a heartfelt commitment to service, brighthush has become the go‑to partner for employers worldwide who want to offer benefits that are both comprehensive and effortless to navigate. Our mission is simple yet powerful: transform the often complex world of employee benefits and claims into a seamless, transparent experience that builds lasting trust and satisfaction.

Our platform integrates real‑time analytics, automated claim adjudication, and a conversational interface that guides employees through every step of the benefits journey. Harnessing machine learning, we reduce processing time, increase accuracy, and free up human talent to focus on high‑impact, relationship‑building work. In a world where employee experience is a key differentiator, brighthush is the partner that helps companies stay ahead of regulatory change, market trends, and the evolving expectations of a modern workforce.

Why This Role Matters – The Impact of a Senior Claims Processing & Customer Experience Specialist

As a Senior Claims Processing & Customer Experience Specialist, you will be the frontline ambassador for our clients. You’ll guide claimants through every step of the journey, ensuring they feel heard, supported, and confident that their needs are being met. Your work will directly influence thousands of lives, shaping the perception of our brand and the loyalty of our partners.

In this role, you will blend deep product knowledge with a genuine passion for customer service. You will become the voice of brighthush in the field, translating complex policy details into clear, actionable guidance. Your expertise will help us maintain the high standards of quality and compliance that our clients expect, while also driving continuous improvement in our processes and technology.

Key Responsibilities – Your Day‑to‑Day Impact

• Customer Engagement: Serve as the primary point of contact for claimants, delivering timely, accurate information on claim status, required documentation, and next steps.
• Data Stewardship: Record all interactions and claim details in our CRM with precision, ensuring data integrity and compliance with regulatory standards.
• Issue Resolution: Resolve routine inquiries and claim issues using company policies, while maintaining a high level of service quality.
• Escalation Management: Identify complex or unresolved claims, coordinate with internal teams (claims adjusters, underwriting, compliance), and ensure seamless handoffs.
• Cross‑Functional Collaboration: Work closely with claims, underwriting, and compliance teams to close the claims lifecycle efficiently.
• Product & Regulatory Mastery: Stay current on product offerings, policy updates, and industry regulations to provide accurate guidance.
• Continuous Improvement: Participate in quality initiatives, share best practices, and contribute to process enhancements that elevate the customer journey.
• Quality Assurance: Adhere to call monitoring, performance metrics, and customer satisfaction standards to maintain excellence.
• Mentorship: Support onboarding and development of new team members, sharing expertise and fostering a culture of learning.
• Technology Adoption: Champion the use of new tools and features within the brighthush platform, providing feedback to product teams.
• Compliance Oversight: Ensure all claim handling activities meet HIPAA, GDPR, and state‑specific insurance regulations.

Essential Qualifications – What We Expect

• GED or high school diploma (or equivalent).
• 2–3 years of experience in a call center or customer service role, preferably within insurance or financial services.
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and web‑based applications.
• Reliable high‑speed home internet and a quiet workspace conducive to focused work.
• Flexibility to work a variety of shifts, including early mornings, evenings, weekends, and holidays, within the Arizona time zone.
• Strong verbal and written communication skills in English.
• Ability to sit for extended periods and manage a high volume of calls with professionalism and composure.
• Basic troubleshooting skills for common software and connectivity issues.

Preferred Qualifications – Bonus Points

• Experience in claims processing or insurance customer support.
• Familiarity with CRM platforms such as Salesforce or Zendesk, and claims management systems.
• Knowledge of regulatory compliance standards (HIPAA, GDPR, state‑specific insurance regulations).
• Demonstrated problem‑solving skills and the ability to think critically under pressure.
• Previous remote or hybrid work experience, showcasing self‑discipline and time‑management.
• Multilingual capabilities or experience serving diverse populations.
• Certifications in claims management or customer experience (e.g., Certified Claims Professional, CX Certification).

Core Skills & Competencies – The DNA of Success at brighthush

• Customer‑Centric Mindset: A genuine desire to help others and a commitment to delivering exceptional service.
• Communication: Clear, concise, and empathetic communication—both verbal and written.
• Technical Proficiency: Comfortable navigating multiple software platforms and troubleshooting basic technical issues.
• Attention to Detail: Accuracy in data entry, documentation, and adherence to policies.
• Time Management: Ability to prioritize tasks, manage call queues, and meet performance metrics.
• Adaptability: Quick to learn new processes, adjust to changing priorities, and embrace continuous improvement.
• Team Collaboration: Willingness to work closely with peers, managers, and other departments to achieve shared goals.
• Problem‑Solving: Analytical mindset to diagnose issues and propose effective solutions.
• Resilience: Ability to maintain composure and positivity in high‑pressure situations.

Career Growth & Development – Your Path Forward

At brighthush, we invest in your professional journey. As a Senior Claims Processing & Customer Experience Specialist, you will have access to:

• Structured onboarding and mentorship programs that accelerate your integration into the team.
• Ongoing training modules covering product knowledge, regulatory updates, and advanced customer service techniques.
• Opportunities to pursue industry certifications (e.g., Certified Claims Professional, Customer Experience Management).
• Clear career pathways to roles such as Claims Analyst, Team Lead, or Customer Experience Manager.
• Regular performance reviews and goal‑setting sessions to align your growth with brighthush’s strategic objectives.
• Cross‑functional project assignments that broaden your skill set and expose you to new areas of the business.
• Access to a global network of professionals through virtual conferences, webinars, and internal knowledge‑sharing forums.

Work Environment & Culture – Where Innovation Meets Inclusion

brighthush champions a flexible, inclusive, and collaborative culture. As a remote team member, you will enjoy:

• Full‑time remote work with a flexible schedule that respects work‑life balance.
• Access to a virtual collaboration hub—video conferencing, instant messaging, and project management tools—to stay connected with teammates.
• A supportive environment that encourages open dialogue, idea sharing, and continuous feedback.
• Regular virtual team events, wellness initiatives, and community outreach projects to foster camaraderie.
• Commitment to diversity, equity, and inclusion—ensuring every voice is heard and valued.
• Annual “Innovation Day” where teams pitch new ideas that could shape the future of employee benefits.
• Recognition programs that celebrate both individual achievements and team milestones.

Compensation & Benefits – Rewarding Your Expertise

Salary Range: USD 40,040 – 54,038 per year (based on experience and qualifications).

Performance Incentives: Potential for quarterly bonuses tied to individual and team metrics.

Retirement Plans: 401(k) with company match to help secure your future.

Health & Wellness: Comprehensive medical, dental, and vision coverage, along with mental health resources.

Paid Time Off: Generous vacation, sick leave, and personal days to recharge.

Parental Leave: Generous paid parental leave for new parents.

Professional Development: Tuition reimbursement and access to online learning platforms.

Other Perks: Flexible work hours, remote work stipend, and employee recognition programs.

Why Join brighthush? – The Brighter Future Starts Here

When you join brighthush, you become part of a forward‑thinking team that is reshaping the employee benefits landscape. You’ll work with cutting‑edge technology, collaborate with industry experts, and have the autonomy to innovate and improve the customer experience. Our culture values curiosity, resilience, and a relentless focus on delivering value to our clients. We celebrate successes, learn from challenges, and continuously evolve to stay ahead of the curve.

How to Apply – Take the Next Step

If you are passionate about delivering outstanding customer experiences, thrive in a dynamic environment, and want to grow your career with a forward‑thinking organization, we encourage you to apply today. Submit your resume and a brief cover letter outlining why you are the ideal fit for the Senior Claims Processing & Customer Experience Specialist role at brighthush. Join us in shaping the future of claims support and making a difference in the lives of our clients.