Senior Peer Review Customer Service Representative – Claims Processing, Client Support & Regulatory Compliance Specialist – Remote, High‑Impact Role at brighthush

About brighthush

brighthush is a trailblazing technology and consulting powerhouse that empowers insurance carriers, managed care organizations, and employers to transform claims management and elevate client outcomes. With a proven track record of processing over 200,000 insurance claims annually, we specialize in Workers’ Compensation, Disability, Auto, and Group Health programs, as well as Independent Medical Exams and Peer Review services. Our culture is built on high performance, continuous learning, and an unwavering commitment to customer satisfaction. At brighthush, every team member’s contribution matters, and we celebrate collaboration, innovation, and integrity.

Position Overview

As a Senior Peer Review Customer Service Representative, you will be the first line of contact for new cases, ensuring accurate system setup and seamless case assignment. You will play a pivotal role in the peer review process, coordinating with medical professionals, claim handlers, and clients to deliver timely, accurate determinations. This role is ideal for a detail‑oriented, customer‑focused professional who thrives in a fast‑moving environment and is eager to grow within the insurance and healthcare technology sector.

Key Responsibilities

• Case Intake & System Setup: Receive new cases, verify documentation, and configure case details in our proprietary claims management platform.
• Case Assignment & Scheduling: Coordinate with internal teams and external medical reviewers to assign cases, schedule evaluations, and track progress.
• Client Communication: Serve as the primary point of contact for clients, providing updates, clarifying requirements, and ensuring a positive experience.
• Quality Assurance: Review case files for completeness, accuracy, and compliance with industry regulations and company policies.
• Data Management: Maintain meticulous records, update case statuses, and generate reports for management and stakeholders.
• Process Improvement: Identify bottlenecks, propose workflow enhancements, and collaborate with cross‑functional teams to optimize efficiency.
• Compliance & Documentation: Adhere to HIPAA, OSHA, and other regulatory standards, ensuring all documentation is secure and confidential.
• Remote Work Support: Maintain an uninterrupted internet connection, manage time effectively, and stay connected with the brighthush team via virtual collaboration tools.

Essential Qualifications

• Associate’s degree or equivalent experience in business, healthcare administration, or a related field.
• Minimum of 1–2 years of experience in a customer service or claims processing role within the healthcare or insurance industry.
• Exceptional written and verbal communication skills, with the ability to explain complex processes to diverse audiences.
• Strong critical thinking and problem‑solving abilities, capable of managing multiple priorities and meeting tight deadlines.
• Proficient computer literacy, including advanced typing skills (minimum 45 WPM) and experience with Microsoft Office Suite and cloud‑based platforms.
• Demonstrated ability to work independently in a remote environment, maintaining focus and productivity.
• High level of integrity and commitment to confidentiality and data security.

Preferred Qualifications

• Bachelor’s degree in Healthcare Administration, Business Administration, or a related discipline.
• Experience with peer review or independent medical exam processes.
• Familiarity with claims management software such as ClaimCenter or Medisoft.
• Knowledge of Workers’ Compensation, Disability, Auto, and Group Health regulations.
• Previous remote work experience with a proven track record of meeting performance metrics.

Skills & Competencies

• Customer‑Centric Mindset: Passion for delivering outstanding service and building lasting client relationships.
• Attention to Detail: Meticulous approach to data entry, documentation, and quality control.
• Time Management: Ability to prioritize tasks, manage competing deadlines, and maintain high productivity.
• Collaboration: Comfortable working cross‑functionally with medical reviewers, claims adjusters, and IT support.
• Adaptability: Quick to learn new systems, policies, and industry trends.
• Analytical Thinking: Strong problem‑solving skills, with a data‑driven approach to process improvement.

Career Growth & Learning Opportunities

At brighthush, we believe in nurturing talent and providing clear career pathways. As a Senior Peer Review Customer Service Representative, you will have the opportunity to:

• Advance to Senior Peer Review Coordinator or Claims Analyst roles.
• Participate in leadership development programs and mentorship initiatives.
• Attend industry conferences, webinars, and training sessions to stay ahead of regulatory changes.
• Earn certifications such as Certified Claims Professional (CCP) or Certified Medical Reviewer (CMR) through our tuition reimbursement program.
• Contribute to cross‑departmental projects, gaining exposure to product development, compliance, and technology teams.

Work Environment & Company Culture

brighthush fosters a collaborative, inclusive, and high‑energy culture. Key highlights include:

• Remote‑First Flexibility: Work from anywhere with a fully equipped home office, including Apple hardware and a media stipend.
• Team Collaboration: Regular virtual huddles, brainstorming sessions, and social events to keep the team connected.
• Innovation‑Driven: A culture that encourages experimentation, continuous improvement, and creative problem‑solving.
• Recognition & Rewards: Employee recognition programs, spot bonuses, and performance‑based incentives.
• Well‑Being Focus: Comprehensive health, dental, and vision plans, along with mental health resources and wellness programs.

Compensation & Benefits

While specific salary ranges are tailored to experience and qualifications, brighthush offers a competitive compensation package that includes:

• Base salary commensurate with industry standards.
• Performance‑based bonuses and incentive plans.
• Health, dental, and vision insurance for you and your family.
• Voluntary life insurance, hospital indemnity, critical illness, accident indemnity, and pet insurance options.
• Basic life insurance, short‑term and long‑term disability coverage at no cost.
• Generous paid time off (PTO) policy, including vacation, sick leave, and holidays.
• 401(k) retirement plan with company match.
• Apple equipment and a media stipend for remote workspace.
• Professional development stipend and tuition reimbursement for relevant certifications.

How to Apply

If you are a proactive, customer‑focused professional ready to make an impact in the insurance and healthcare technology space, we invite you to apply for the Senior Peer Review Customer Service Representative position at brighthush. Submit your resume and a cover letter highlighting your relevant experience and why you are excited about this role. Join us in delivering exceptional service, driving innovation, and shaping the future of claims management.

Join brighthush Today

At brighthush, we are committed to building a diverse, inclusive, and high‑performing team. We value curiosity, resilience, and a passion for continuous improvement. If you are ready to grow, learn, and contribute to a company that rewards excellence, we encourage you to apply now and become part of our dynamic, forward‑thinking community.