Senior Customer Claims Specialist – Remote Claims Processing & Customer Experience Excellence – Lead Claims Management & Process Optimization at brighthush

About brighthush

brighthush stands at the forefront of the global managed services arena, delivering unparalleled customer support, claims management, and digital transformation solutions to Fortune 500 enterprises across the Americas, EMEA, and APAC. With a dynamic workforce of more than 9,000 professionals operating from 13 strategically located delivery centers, we fuse deep industry expertise with a culture that champions diversity, inclusion, and continuous learning. Our mission is simple yet powerful: empower every employee to bring their authentic self to work and help our clients achieve operational excellence.

Why brighthush?

At brighthush, we believe people are our most valuable asset. That conviction translates into a comprehensive package of rewards, growth opportunities, and a culture that nurtures both professional and personal development.

• Competitive Rewards – Above‑market base salary, immediate healthcare coverage for you and your dependents, paid time off with cash conversion, group life insurance, and performance‑based bonuses.
• Collaborative Spirit – A vibrant community that thrives on teamwork, cross‑functional projects, and company‑sponsored events.
• Work‑Life Harmony – Flexible remote work arrangements and shifting schedules that let you balance professional growth with personal commitments.
• Career Growth – Structured learning paths, mentorship programs, and internal mobility opportunities that help you advance from specialist to leader.
• Inclusive Culture – A workplace where every voice is heard, diversity is celebrated, and inclusion is a lived value.

Position Overview

As a Senior Customer Claims Specialist at brighthush, you will be the linchpin in our claims processing ecosystem. You will manage the entire lifecycle of customer claims, ensuring accuracy, compliance, and exceptional service. Your role blends analytical rigor with empathetic communication, driving both operational efficiency and customer satisfaction.

What You’ll Do

• End‑to‑End Claims Management – Oversee the full claims journey from initial intake, through assessment, approval, resolution, and payment, ensuring each step meets our high standards of quality and speed.
• Policy & Regulatory Compliance – Evaluate claims against policy terms, insurance guidelines, and regulatory standards to guarantee fair and accurate decisions.
• Documentation & Record Keeping – Maintain meticulous, up‑to‑date claim records, supporting evidence, and audit trails that can withstand internal and external reviews.
• Customer Communication – Provide clear, timely updates to customers via email, chat, or phone, resolving queries with empathy and professionalism.
• Fraud Detection & Escalation – Identify potential fraud or irregularities, escalating suspicious claims for deeper investigation and safeguarding our clients’ interests.
• Collaboration with Leadership – Partner with the Team Lead to resolve complex claims and align on best practices, ensuring continuous improvement.
• Performance Metrics – Meet or exceed KPIs such as turnaround time, accuracy, productivity, and customer satisfaction scores, driving operational excellence.
• Process Improvement – Recommend and implement process enhancements that boost efficiency, reduce errors, and elevate the customer experience.
• Team Development – Mentor junior assessors, share knowledge, and champion best practices across the team, fostering a culture of learning.

Support & Administrative Duties

• Ticket Triage – Sort incoming tickets into appropriate inboxes across systems like Zendesk and XClaim, ensuring swift routing.
• Cross‑Channel Resolution – Own the resolution of customer and partner inquiries across email, chat, and phone, maintaining a consistent tone.
• Process Implementation – Lead the rollout of new processes to achieve individual and team KPIs, ensuring smooth adoption.
• Quality Assurance – Ensure high standards of presentation, accuracy, and detail in every case, conducting spot checks and audits.
• Administrative Support – Manage partner site tasks such as invoice uploads and document uploads, and translate tickets using Google Translate when necessary.

Essential Qualifications

• Bachelor’s degree in Business, Finance, or a related field.
• Minimum of 3 years’ experience in claims processing, customer support, or a related role.
• Strong understanding of insurance policies, regulatory compliance, and claims adjudication.
• Proficiency with CRM and ticketing systems (Zendesk, XClaim, Salesforce, etc.).
• Excellent written and verbal communication skills in English; additional languages are a plus.
• High attention to detail, analytical mindset, and problem‑solving aptitude.
• Ability to work independently in a remote environment while collaborating across time zones.

Preferred Qualifications

• Experience in a high‑volume, fast‑paced claims environment.
• Knowledge of fraud detection tools and techniques.
• Certification in Claims Management or related field (e.g., CPC, CCA).
• Experience with process improvement methodologies such as Lean or Six Sigma.
• Proficiency in data analysis tools (Excel, Power BI, Tableau).

Core Skills & Competencies

• Customer‑Centric Mindset – Passion for delivering exceptional service and turning challenges into opportunities.
• Analytical Thinking – Ability to dissect complex claims and identify root causes.
• Communication Excellence – Clear, concise, and empathetic communication across multiple channels.
• Adaptability – Thrive in a dynamic environment with evolving processes and priorities.
• Collaboration & Leadership – Work effectively with cross‑functional teams and mentor peers.
• Technology Savvy – Comfortable navigating multiple digital platforms and learning new tools quickly.

Career Growth & Learning Opportunities

At brighthush, your career trajectory is designed to evolve with your ambitions. As a Senior Customer Claims Specialist, you will:

• Progress to a Lead Claims Analyst role, overseeing larger teams and more complex cases.
• Transition into a Process Improvement Manager, shaping the future of our claims operations.
• Explore cross‑functional roles in Customer Experience, Operations, or Product Management.
• Participate in our Leadership Development Program, which includes mentorship, executive coaching, and rotational assignments.
• Access continuous learning resources such as online courses, certifications, and industry conferences.

Work Environment & Culture

brighthush’s culture is built on three pillars:

• Innovation – We encourage experimentation, reward creative solutions, and invest in cutting‑edge technology.
• Inclusivity – Every employee, regardless of background, is valued and empowered to contribute.
• Well‑Being – Flexible schedules, mental health resources, and wellness programs keep our team energized.

Our remote‑first model means you can work from anywhere, but we also host quarterly virtual town halls, monthly hackathons, and annual retreats to foster connection and collaboration.

Compensation & Benefits

While specific figures vary by role and location, brighthush offers:

• Competitive base salary with performance bonuses.
• Immediate health, dental, and vision coverage for you and your dependents.
• Paid time off with a cash‑conversion option.
• Group life insurance and disability coverage.
• Employee stock purchase plan (ESPP) and retirement savings match.
• Wellness stipend, gym membership discounts, and mental health support.
• Professional development budget and tuition reimbursement.

How to Apply

If you’re ready to bring your expertise in claims management to a forward‑thinking, inclusive organization, we’d love to hear from you. Submit your application through our careers portal or click the link below to start your journey with brighthush.

Apply to this role at brighthush

Join brighthush – Where Your 100% You Makes a Difference

At brighthush, we don’t just hire talent; we nurture it. We celebrate the unique perspectives each team member brings, creating an environment where innovation thrives and careers flourish. If you’re passionate about delivering world‑class customer service, eager to grow in a dynamic environment, and ready to make a tangible impact, we invite you to apply today.