Senior Remote Health Plans Customer Service Advocate – Expert Claims & Benefits Support Specialist – Champion Member Experience & Continuous Improvement at brighthush

Welcome to brighthush – Where Care Meets Innovation

At brighthush, we’re redefining what it means to provide health care in the 21st century. Born from a humble clinic in the early 1900s, we have evolved into a national powerhouse that delivers seamless medical, virtual, and in‑person care to millions of members across the United States. Our integrated ecosystem blends patient‑centered clinical services, cutting‑edge research, and comprehensive health‑plan solutions into a single, friction‑free experience. Every interaction—whether a phone call, an email, or a virtual visit—reflects our core values of compassion, innovation, and continuous learning.

Why brighthush is the Place to Grow Your Career

When you join brighthush, you become part of a vibrant, collaborative community that values every voice. Our remote‑first model empowers you to work from anywhere in the United States while staying connected to a dynamic team. We champion professional growth through mentorship, cross‑functional projects, and ongoing training. Whether you’re a seasoned customer‑service veteran or a recent graduate eager to learn, brighthush offers the resources, support, and recognition you need to thrive.

Role Overview

As a Senior Remote Health Plans Customer Service Advocate, you will be the frontline champion for our members, providers, and partner organizations. Your primary focus will be to deliver accurate, empathetic, and timely support on all aspects of health‑plan benefits, eligibility, claims, and provider network status. You will operate in a high‑volume call center environment, collaborating with billing departments, insurance partners, and internal teams to resolve complex inquiries and ensure a seamless member experience.

Key Responsibilities

• Brand Ambassador: Represent brighthush in every interaction, embodying our mission, vision, and values while delivering exceptional service.
• Team Culture Builder: Foster a positive, productive team culture by sharing best practices, celebrating successes, and offering constructive feedback.
• Performance Excellence: Meet or exceed customer‑service performance metrics, including average call handling time, resolution rate, and member satisfaction scores.
• Claims Adjudication Expert: Explain the adjudication process for claims, detailing how deductibles, co‑pays, co‑insurance, and provider reimbursements are allocated.
• Multi‑Channel Support: Provide prompt, accurate assistance to members, providers, billing departments, and other insurance carriers regarding claims, benefits, eligibility, and network status.
• CRM Stewardship: Document all interactions in the customer‑relationship management (CRM) system, ensuring data integrity and following up on outstanding issues.
• Issue Resolution: Resolve claim‑related problems, escalating to appropriate teams when necessary, and ensuring a smooth resolution path for all stakeholders.
• Email & Digital Communication: Monitor and respond to customer inquiries via email, ensuring timely and professional communication.
• Process Improvement: Collaborate with cross‑functional teams to identify process improvements and contribute to continuous quality initiatives.
• Knowledge Sharing: Mentor new hires and share insights on best practices, policy updates, and system enhancements.

Essential Qualifications

• Experience: Minimum of one year in a customer‑service or call‑center role, preferably within the health‑care or insurance industry.
• Problem‑Solving: Demonstrated ability to handle complex inquiries and resolve issues efficiently.
• Organizational Skills: Strong organizational, time‑management, and project‑management skills, with the ability to multitask in a fast‑paced environment.
• Communication: Excellent written and verbal communication skills, with a keen attention to detail and a problem‑solving mindset.
• Technical Proficiency: Proficiency in navigating multiple computer programs and resources, including CRM systems, Microsoft Office Suite, and web‑based research tools.
• Professionalism: Ability to work independently, as well as collaboratively within a team, while maintaining a high level of professionalism and empathy.
• Adaptability: Comfortable adjusting to new policies, procedures, and technology updates on a regular basis.

Preferred Qualifications

• Health‑Plan Expertise: Experience with health‑plan benefits, eligibility verification, and claims adjudication.
• Network Knowledge: Knowledge of provider network structures, reimbursement models, and payer‑provider relationships.
• Regulatory Awareness: Familiarity with health‑care regulations, privacy laws (HIPAA), and compliance standards.
• Remote Work Experience: Previous experience in a remote or virtual work setting, demonstrating self‑discipline and effective communication.
• Certification: Certification or coursework in health‑care administration, customer‑service management, or related fields.
• Data Analytics: Ability to interpret and utilize data to drive service improvements and report on key metrics.

Skills & Competencies

• Customer‑Centric Mindset: Passion for delivering exceptional service and building lasting relationships.
• Analytical Thinking: Ability to interpret complex data to support decision‑making.
• Interpersonal Skills: Strong interpersonal skills, enabling you to build rapport with diverse stakeholders.
• Adaptability: Adaptability and resilience in a dynamic, evolving environment.
• Tech‑Savvy: Comfortable with learning new systems and tools quickly.
• Growth Orientation: Commitment to continuous improvement and a growth‑oriented attitude.
• Team Collaboration: Ability to work effectively with cross‑functional teams, including billing, claims, and provider relations.

Career Growth & Learning Opportunities

At brighthush, we believe in nurturing talent from within. As a Senior Customer Service Advocate, you will have access to:

• Structured onboarding and mentorship programs to accelerate your learning curve.
• Cross‑training opportunities across billing, claims, and provider relations teams.
• Leadership development tracks for high‑performing team members.
• Regular workshops, webinars, and certifications in health‑care operations and customer‑experience design.
• Clear career pathways to roles such as Claims Analyst, Provider Relations Specialist, or Customer Experience Manager.
• Access to a dedicated learning portal with courses on health‑care policy, data analytics, and advanced customer‑service techniques.

Work Environment & Culture at brighthush

Our remote‑first model empowers you to work from anywhere in the United States while staying connected to a vibrant, collaborative culture. You’ll enjoy:

• Flexible scheduling that respects your personal commitments.
• Regular virtual team huddles, town‑halls, and social events to foster community.
• A culture that celebrates diversity, equity, and inclusion, ensuring every voice is heard.
• Access to cutting‑edge technology and tools that streamline your workflow.
• Recognition programs that reward innovation, teamwork, and customer‑service excellence.
• Opportunities to contribute to community outreach and health‑education initiatives.

Compensation & Benefits

While specific salary ranges are not disclosed in the posting, brighthush offers a competitive compensation package that includes:

• Base salary commensurate with experience and market standards.
• Performance‑based bonuses and incentive plans.
• Comprehensive health, dental, and vision insurance plans.
• 401(k) retirement plan with company match.
• Paid time off, holidays, and flexible sick leave.
• Professional development budget and tuition reimbursement.
• Employee wellness programs, including virtual fitness classes and mental‑health resources.
• Technology stipend for home‑office setup.
• Employee stock purchase plan and equity options for eligible roles.

How to Apply

Ready to make a meaningful impact in the health‑care industry? Submit your application through our online portal or click the link below to join the brighthush team. We look forward to learning how your skills, passion, and experience align with our mission to deliver exceptional member experiences.

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