Senior Health Plan Support & Billing Specialist – Remote Customer Service Representative (MD) – Championing Member Care Excellence & Innovative Billing Solutions at brighthush

Introduction: Join brighthush and Shape the Future of Health Coverage

In a world where health coverage is evolving faster than ever, brighthush stands at the forefront of innovation, redefining how individuals experience and interact with their health plans. We are more than a provider; we are a movement dedicated to empowering every member with reliable, accessible, and personalized care. Our culture is rooted in integrity, collaboration, and continuous improvement, and we invite you to be part of this transformative journey.

Why brighthush is a Trailblazer in the Health Plan Industry

brighthush has earned a reputation for excellence through a relentless focus on innovation, data‑driven decision making, and a member‑centric philosophy. Our approach is built on five pillars that set us apart:

• Member‑Centric Philosophy: Every policy, process, and technology is designed with the member’s experience at its core.
• Data‑Driven Excellence: Advanced analytics help us refine workflows, predict member needs, and measure impact.
• Technology Innovation: From AI‑powered chatbots to next‑generation billing platforms, we invest in tools that streamline member interactions.
• Diversity & Inclusion: Our workforce mirrors the communities we serve, ensuring a broad range of perspectives and ideas.
• Community Impact: We partner with local organizations to promote health literacy, wellness, and preventive care.

Key Responsibilities: Your Role as a Member Advocate and Billing Expert

As a Senior Health Plan Support & Billing Specialist, you will manage a wide array of duties that span multiple product lines and service areas. Your day‑to‑day tasks will include:

• Member Core Support: Resolve facility inquiries, provide web support, promote the brighthush online portal, process ID card orders, manage complaints, and conduct service reviews.
• Member Advanced Support: Handle eligibility and benefit inquiries, manage general and complaint cases, process correspondence, add or remove dependents, and oversee new member onboarding.
• Internal Regional Requests: Coordinate with regional teams to resolve IVR defaults and Medicare‑related issues for up to two regions.
• Premium Billing: Process billing inquiries, accept payments, manage EFT inquiries, handle reinstatement requests, and provide 1095 tax form assistance.
• Enterprise Billing: Resolve complex billing issues, including KPC Billing (now branded as brighthush Billing), and handle escalations to Tier 3 for SLP* cases.
• Documentation & Compliance: Accurately record all interactions in the Member Service Contact Center (MSCC) system, ensuring adherence to privacy, confidentiality, and regulatory standards.
• Problem Solving & Escalation: Evaluate data, determine appropriate actions, and coordinate service recovery to resolve complaints and improve member experience.
• Continuous Improvement: Participate in quality assurance reviews, provide feedback on process enhancements, and stay current with policy updates.

Essential Qualifications: What You Need to Succeed

• Minimum of two (2) years of customer service experience, preferably in a call center environment.
• High School Diploma or General Education Development (GED) required.
• Typing speed of at least 30 words per minute (WPM) with a current typing test within one year of the posting.
• Excellent written and verbal communication skills, with the ability to articulate complex information clearly and concisely.
• Strong analytical and problem‑solving abilities, capable of evaluating data and determining appropriate solutions.
• Proficiency with MSCC systems and other customer service tools used within brighthush.
• Demonstrated ability to read, interpret, and respond to member inquiries efficiently.
• Critical thinking skills and a proactive approach to resolving issues.
• Commitment to maintaining privacy, confidentiality, and compliance with all regulatory requirements.

Preferred Qualifications: What Will Set You Apart

• Experience in a call center or contact center setting.
• Background in health insurance or related fields.
• Knowledge of Medicare and Medicaid policies.
• Familiarity with billing and payment processing systems.
• Experience with IVR systems and regional coordination.

Skills & Competencies: The Attributes That Drive Success

• Customer‑Centric Mindset: Passion for delivering outstanding service and building lasting relationships.
• Communication: Clear, concise, and empathetic communication across multiple channels.
• Technical Proficiency: Comfortable navigating complex systems, databases, and software tools.
• Time Management: Ability to prioritize tasks, manage multiple inquiries simultaneously, and meet performance metrics.
• Adaptability: Thrive in a fast‑paced environment with evolving policies and procedures.
• Team Collaboration: Work effectively with cross‑functional teams, including medical groups, facilities, and regional offices.
• Compliance Awareness: Adhere to privacy laws, data protection standards, and internal compliance guidelines.

Career Growth & Learning Opportunities: Invest in Your Future

At brighthush, we believe that growth is a shared journey. As a Senior Health Plan Support & Billing Specialist, you will have access to:

• Structured onboarding and mentorship programs to accelerate your learning curve.
• Regular performance reviews and goal‑setting sessions to identify growth paths.
• Cross‑training opportunities in billing, enrollment, and advanced member services.
• Leadership development tracks for those interested in supervisory or managerial roles.
• Access to industry certifications, such as Certified Customer Service Professional (CCSP) or Health Insurance Associate (HIA).
• Participation in innovation workshops and process improvement initiatives.

Work Environment & Culture at brighthush: Remote, Yet Connected

Our remote work model empowers you to create a productive workspace that suits your lifestyle. Despite the distance, we maintain a vibrant, collaborative culture through:

• Weekly virtual team huddles and monthly all‑hands meetings.
• Digital collaboration tools (Slack, Teams, Zoom) for real‑time communication.
• Annual virtual retreats and quarterly recognition events.
• Inclusive policies that celebrate diversity, equity, and belonging.
• Open‑door leadership philosophy encouraging feedback and innovation.

Compensation, Perks, and Benefits: A Comprehensive Package

While specific figures may vary based on experience, brighthush offers a competitive compensation package that includes:

• Base salary commensurate with industry standards and your experience.
• Performance‑based bonuses tied to key metrics such as first‑call resolution and member satisfaction.
• Health, dental, and vision insurance plans.
• Flexible paid time off (PTO) and holiday schedule.
• 401(k) retirement plan with company match.
• Professional development stipend and tuition reimbursement.
• Employee wellness programs, including virtual fitness classes and mental health resources.
• Technology stipend to support your home‑office setup.

How to Apply: Take the First Step Toward a Rewarding Career

Ready to make a difference in the lives of our members? Click the link below to submit your application and join the brighthush team. We look forward to learning how your skills and passion align with our mission to provide extraordinary customer relations and quality service.

Apply to this job at brighthush

Conclusion: Your Future Starts Here

At brighthush, you will be part of a forward‑thinking organization that values your expertise, encourages growth, and places member satisfaction at the core of everything we do. If you are a dedicated, customer‑focused professional with a passion for health plan support and a desire to thrive in a remote, collaborative environment, we invite you to apply today. Together, we can create a brighter future for our members and our organization.

Apply for this job