Senior Health Plan Support & Billing Specialist – Remote Customer Service Representative (MD) – Empowering Member Care at brighthush

About brighthush and the Health Plan Industry

brighthush stands at the forefront of the health plan landscape, delivering comprehensive coverage solutions that empower individuals and families across the United States. With a relentless focus on innovation, quality, and customer satisfaction, brighthush has earned a reputation for excellence in the health insurance sector. Our mission is simple yet profound: to provide reliable, accessible, and personalized health coverage while fostering a culture rooted in integrity, collaboration, and continuous improvement.

In an era where health plans are evolving rapidly, the demand for skilled customer service professionals who can navigate complex product lines, resolve member inquiries, and uphold the highest standards of compliance has never been greater. At brighthush, we recognize that our members are at the heart of everything we do, and we are committed to delivering the highest level of support and care.

Why Join brighthush?

• Impactful Work: Every interaction you handle directly influences member satisfaction, retention, and the overall experience.
• Remote Flexibility: Work from the comfort of your home while maintaining a healthy work‑life balance.
• Career Growth: Opportunities to advance into senior support roles, team leadership, or specialized product lines.
• Learning & Development: Access to ongoing training, certifications, and industry conferences.
• Inclusive Culture: A diverse, supportive environment that values every voice and encourages innovation.

Key Responsibilities

As a Senior Health Plan Support & Billing Specialist, you will be the frontline advocate for our members, ensuring that every inquiry is handled with professionalism, empathy, and efficiency. Your role will encompass a broad range of duties across multiple product lines and service areas:

• Member Core Support: Handle facility inquiries, web support, promote the brighthush online portal, process ID card orders, manage complaints, and conduct service reviews.
• Member Advanced Support: Address eligibility and benefit inquiries, manage general and complaint cases, handle correspondence inquiries, 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

• 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

• 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

• 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

At brighthush, we invest in our people. 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

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

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

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

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.