Senior Remote Dental & Insurance Claims Customer Service Specialist – 100% Remote, USA – Empowering Member Experience and Provider Success

About brighthush

brighthush is a forward‑thinking, customer‑centric organization that is redefining how people access and experience dental and health insurance services. With a mission to empower members and providers through clear communication, seamless technology, and compassionate support, brighthush has quickly become a trusted partner in the insurance industry. Our remote‑first culture means you can work from anywhere in the United States while enjoying the same collaborative spirit, professional growth, and impact as if you were in the office.

Why Join brighthush?

At brighthush, we believe that exceptional customer service is the cornerstone of a healthy, thriving community. We invest in our people through continuous learning, mentorship, and a culture that celebrates curiosity, resilience, and teamwork. As a Remote Customer Service Representative, 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

In this role, you will serve as the primary point of contact for both dental professionals and members, providing 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

• 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

• Experience with Cisco phone systems or similar telephony platforms.
• 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 like Teams, Slack, or Zoom.

Skills & Competencies

• 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

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.

Work Environment & Company Culture

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.

Compensation & Benefits

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.

How to Apply

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.