Senior Remote Dental & Insurance Claims Customer Service Specialist – 100% Remote, USA – Championing Member Experience, Provider Success, Seamless Claims Resolution, and Advanced Claims Expertise at brighthush

About brighthush

brighthush is more than a technology provider; it is a movement that is redefining how people experience dental and health insurance. By fusing cutting‑edge software with a people‑first philosophy, we empower members to navigate their benefits with confidence and providers to deliver care without administrative friction. Our mission is simple yet powerful: to make every interaction with dental and health insurance a seamless, transparent, and compassionate experience. From the first click on our portal to the final claim settlement, we are committed to turning complex processes into clear, user‑friendly journeys that feel like a conversation with a trusted friend.

Why Remote Work Is the Future of Customer Service – And Why brighthush Is Leading the Charge

Remote work is no longer a trend; it is a strategic advantage that unlocks talent from every corner of the country. At brighthush, we have built a remote‑first culture that feels like an office—one where collaboration, innovation, and community thrive without the constraints of a physical workspace. We invest in our people through continuous learning, mentorship, and a culture that celebrates curiosity, resilience, and teamwork. As a Senior Remote Dental & Insurance Claims Customer Service Specialist, you will be at the heart of our mission—helping members navigate their benefits, resolving complex claims, and ensuring that every interaction reflects the highest standards of care.

Key Responsibilities – Your Impact in Action

As the primary point of contact for both dental professionals and members, you will provide timely, accurate, and empathetic support across multiple channels. Your day‑to‑day tasks will include:

• Claims & Coverage Support: Analyze patient activity, enrollment data, and third‑party liability to resolve coordination of benefits inquiries.
• Coverage Interpretation: Translate complex insurance policies into clear, actionable information for customers and providers.
• Documentation Excellence: Record every interaction in our CRM with meticulous detail, ensuring audit readiness and data integrity.
• Education & Guidance: Conduct training sessions for dental professionals on eligibility, benefits, claims payment, and authorization processes.
• Self‑Service Advocacy: Promote and guide users through our digital tools, enhancing their autonomy and satisfaction.
• Network Navigation: Assist members in locating in‑network dentists or assigning primary care dentists, ensuring seamless access to care.
• Escalation Management: Identify when an issue requires higher‑level intervention and route inquiries to the appropriate department or specialist.
• Multi‑Channel Communication: Respond to inquiries via phone, email, web portal, and chat with professionalism and courtesy.
• Complex Issue Resolution: Handle intricate claims payment questions, research patient activity, and determine the correct course of action.
• Ownership & Follow‑Up: Take full responsibility for issue resolution, set realistic expectations, and ensure timely follow‑through.
• Administrative Compliance: Execute resubmissions, stop payments, and voids in accordance with policy and regulatory requirements.
• Performance Excellence: Meet or exceed individual, departmental, and client‑specific performance metrics.
• Process Improvement: Contribute ideas that enhance service delivery, streamline workflows, and elevate customer experience.
• Additional Duties: Support other team initiatives as needed, demonstrating flexibility and a proactive mindset.

Essential Qualifications – What We Expect

• U.S. citizenship or permanent residency—eligible to work for any U.S. employer without visa sponsorship.
• Minimum of 2 years in a high‑volume customer service environment, preferably within health insurance.
• At least 1 year of experience handling dental or medical claims, billing, and coding.
• Strong knowledge of Medicare, Medicaid, and private insurance coverage structures.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and experience navigating multiple software platforms simultaneously.
• Excellent verbal and written communication skills, with the ability to convey complex information clearly.
• Demonstrated organizational skills, meticulous attention to detail, and the capacity to manage multiple priorities.
• Self‑starter attitude—able to troubleshoot and set up computer equipment with minimal assistance.
• Critical thinking and problem‑solving abilities, coupled with a calm, professional demeanor under pressure.
• High school diploma or equivalent; associate’s or bachelor’s degree in a related field is a plus.

Preferred Qualifications – Bonus Points

• Experience with a leading telephony platform.
• Familiarity with dental terminology and terminology related to oral health services.
• Prior exposure to customer‑service metrics such as CSAT, NPS, or SLA targets.
• Knowledge of HIPAA regulations and data privacy best practices.
• Experience in a remote or virtual team environment, using collaboration tools such as remote collaboration platforms.

Skills & Competencies – The DNA of Success

• Customer‑Centric Mindset: Passion for helping others and a genuine desire to improve member experience.
• Communication: Clear, concise, and empathetic communication across all channels.
• Technical Proficiency: Comfortable learning new software quickly and troubleshooting basic tech issues.
• Adaptability: Thrive in a fast‑paced, evolving environment with changing priorities.
• Team Collaboration: Work effectively with cross‑functional teams, including claims, billing, and provider relations.
• Time Management: Prioritize tasks, meet deadlines, and maintain high productivity.
• Problem Solving: Analyze complex issues, identify root causes, and propose actionable solutions.

Career Growth & Learning Opportunities – Your Path to Excellence

At brighthush, your professional development is a priority. We offer:

• Structured onboarding and continuous training programs covering industry knowledge, product updates, and soft‑skill development.
• Mentorship from seasoned professionals in claims, provider relations, and customer experience.
• Clear career pathways—from Customer Service Representative to Senior Specialist, Team Lead, or Manager roles.
• Access to industry conferences, webinars, and certifications such as Certified Customer Experience Professional (CCXP) or Certified Claims Professional (CCP).
• Regular performance reviews with actionable feedback and personalized growth plans.
• Cross‑functional project opportunities that broaden your skill set and expose you to new areas of the business.
• Leadership training for those aspiring to move into supervisory or managerial positions.

Work Environment & Company Culture – Where Innovation Meets Inclusion

brighthush’s remote‑first culture is built on trust, transparency, and collaboration. You’ll enjoy:

• Flexible work hours that accommodate your personal schedule while meeting business needs.
• Regular virtual team huddles, knowledge‑sharing sessions, and social events to foster connection.
• A supportive, inclusive environment that values diversity of thought and background.
• Access to a digital wellness program, including mental health resources and virtual fitness classes.
• Recognition programs that celebrate achievements, milestones, and innovative ideas.
• Annual “Innovation Day” where teams brainstorm and prototype new service enhancements.
• Transparent communication from leadership through monthly all‑hands meetings and open Q&A sessions.

Compensation & Benefits – Rewarding Your Impact

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

• Base salary commensurate with industry standards for remote customer service roles.
• Performance‑based bonuses and incentive programs.
• Comprehensive medical, vision, and dental insurance plans for you and your dependents.
• 401(k) retirement plan with company match to help you build long‑term financial security.
• Paid time off (PTO), holidays, and sick leave to support work‑life balance.
• Professional development stipend for courses, certifications, and conferences.
• Technology stipend to equip you with the necessary hardware and software for remote work.
• Employee assistance program (EAP) for confidential counseling and support services.
• Flexible work‑from‑home stipend to cover home office expenses.

How to Apply – Join the brighthush Revolution

If you are ready to make a tangible difference in the lives of members and providers while advancing your career in a dynamic, remote environment, we encourage you to apply today. Submit your resume and a brief cover letter outlining your relevant experience and why you’re excited about this role at brighthush.

Join brighthush – Where Service Meets Innovation

At brighthush, you’ll be part of a mission‑driven team that values integrity, innovation, and impact. Your expertise will help shape the future of dental and health insurance customer experience, ensuring that every member receives the support they need to thrive. If you’re passionate about delivering exceptional service, eager to grow, and ready to work in a flexible, remote setting, we want to hear from you.

Apply now and become a vital part of brighthush’s journey to transform the way people access and understand their dental and health benefits.