Senior Remote Healthcare Customer Service Representative – Patient Care Coordinator & Referral Specialist (USA) – Champion Compassionate Care & Seamless Referrals at brighthush

Welcome to brighthush – Where Compassion Meets Innovation

At brighthush, we’re not just a technology partner; we’re a movement that redefines how patients, providers, and payers navigate the intricate world of medical coverage. Our mission is bold yet clear: to streamline care coordination, elevate the patient experience, and empower every stakeholder with empathy, efficiency, and relentless innovation. Whether you’re a seasoned professional or a recent graduate eager to make a tangible difference, brighthush offers a dynamic, inclusive environment where your expertise can thrive and your career can accelerate.

Why This Role Matters

The frontline of patient support is more critical than ever. As a Remote Healthcare Customer Service Representative, you become the voice that guides patients through insurance complexities, the bridge that connects providers to the right resources, and the advocate who ensures every interaction is handled with compassion and precision. Your work directly impacts patient satisfaction, provider efficiency, and the overall health of our ecosystem. In a world where healthcare decisions can feel overwhelming, you are the steady hand that brings clarity and confidence.

Key Responsibilities

As a Remote Healthcare Customer Service Representative at brighthush, you will:

• Handle inbound and outbound communications—calls, emails, and chat inquiries—to assess patient and provider needs, striving for one‑call resolution whenever possible.
• Report adverse events and critical incidents within the required timeframe, ensuring compliance with regulatory standards and safeguarding patient safety.
• Create, process, and complete accurate referrals and applications—staying current on policy or procedural changes that affect coverage decisions.
• Investigate and resolve patient and physician inquiries—providing timely, evidence‑based answers that reflect the latest payer guidelines.
• Enter detailed information into proprietary software while maintaining a conversational, empathetic tone with callers.
• Conduct outbound follow‑up calls to confirm appointments, gather missing documentation, and ensure smooth enrollment.
• Demonstrate superior customer support skills—active listening, conflict resolution, and cultural sensitivity—to build trust and rapport.
• Collaborate with referral sources—hospitals, clinics, and community partners—to process new applicants efficiently.
• Steward patient accounts from initial contact through final approval or denial, ensuring all documentation is complete and accurate.
• Prioritize multiple concurrent assignments—managing time effectively while maintaining a high level of service quality.
• Maintain quality standards by controlling the conversation flow, educating callers on processes, and providing clear, actionable guidance.
• Apply knowledge of job and company policies to complete a variety of assignments independently.
• Demonstrate in‑depth knowledge of technical or specialty areas, such as Medicare, Medicaid, or commercial payer policies.
• Apply advanced problem‑solving skills to resolve complex issues independently, escalating only when necessary.
• Modify processes to improve efficiency and customer satisfaction, contributing to continuous improvement initiatives.
• Work independently within established procedures, while providing general guidance or technical assistance to less experienced team members.

Essential Qualifications

To thrive in this role, you should possess:

• 1–3 years of relevant professional experience, preferably in customer service or call center environments within healthcare or insurance.
• Excellent written and oral communication skills, with a proven ability to mediate, negotiate, and resolve conflicts.
• Strong interpersonal skills that demonstrate flexibility, persistence, creativity, empathy, and trustworthiness.
• Robust computer literacy, including data entry proficiency and familiarity with MS Office and other office productivity tools.
• A minimum of a High School Diploma or GED; a bachelor’s degree in Health Administration, Business, or a related field is a plus.
• Clear knowledge of Medicare, Medicaid, and commercial payer policies and guidelines for coverage.
• Understanding of Diagnostic Medical Expense (DME) and Medicare Administrative Contractor (MAC) practices.
• Clear understanding of medical, supplemental, and pharmacy insurance benefit practices.
• Fluency in both English and Spanish is highly preferred, but not mandatory.

Preferred Qualifications

We’ll be even more excited if you bring:

• Experience in a healthcare or insurance call center, handling complex eligibility or claims inquiries.
• Knowledge of electronic health record (EHR) systems and patient management platforms.
• Experience with remote work tools such as Zoom, Teams, and cloud‑based CRM systems.
• Certification in Customer Service Excellence or a related field.
• Experience in a bilingual environment, providing support to diverse patient populations.

Skills & Competencies

• Customer‑centric mindset: Always put the patient first, ensuring a supportive and respectful experience.
• Problem‑solving: Quickly identify root causes and implement effective solutions.
• Time management: Balance multiple tasks while meeting performance metrics.
• Attention to detail: Maintain accuracy in data entry and documentation.
• Adaptability: Thrive in a fast‑changing environment and embrace new technologies.
• Team collaboration: Share knowledge and support colleagues, fostering a positive work culture.
• Compliance awareness: Adhere to HIPAA, GDPR, and other privacy regulations.

Career Growth & Learning Opportunities

At brighthush, we invest in your professional development. You’ll have access to:

• On‑boarding training that covers industry best practices, software proficiency, and regulatory compliance.
• Ongoing learning modules, webinars, and workshops on emerging healthcare trends, payer policies, and customer service techniques.
• Mentorship programs that pair you with experienced leaders for guidance and career advice.
• Clear career pathways: From Customer Service Representative to Senior Coordinator, Team Lead, or Manager roles.
• Performance‑based promotions and salary increases that reward your dedication and results.

Work Environment & Culture

Our remote team operates in a supportive, flexible environment that values work‑life balance. You’ll enjoy:

• Full‑time remote work with a reliable home office setup provided by brighthush.
• Regular virtual team meetings, social events, and community outreach initiatives.
• A culture of transparency, where your ideas are heard and your contributions are recognized.
• Inclusive policies that celebrate diversity, equity, and belonging.
• Access to mental health resources, wellness programs, and employee assistance plans.

Compensation, Perks, and Benefits

While specific figures may vary based on experience and location, brighthush offers:

• Competitive base salary aligned with industry standards for remote healthcare customer service roles.
• Performance bonuses tied to key metrics such as call resolution time, customer satisfaction scores, and referral accuracy.
• Health, dental, and vision insurance options, with coverage for you and your dependents.
• Flexible paid time off (PTO) and paid holidays.
• 401(k) retirement plan with company match.
• Professional development stipend to support certifications, courses, or conferences.
• Technology stipend to maintain a high‑quality home office setup.
• Employee wellness programs, including virtual fitness classes and mental health support.

How to Apply

If you’re ready to bring your passion for patient care, your strong communication skills, and your dedication to excellence to a forward‑thinking organization, we want to hear from you. Submit your application through our career portal or click the link below to start your journey with brighthush.

Apply to This Job

Join brighthush Today

At brighthush, you’re not just filling a role—you’re becoming part of a mission to transform healthcare customer service. Your expertise will help patients navigate their coverage, your empathy will ease their journey, and your growth will be supported every step of the way. If you’re ready to make a meaningful impact from the comfort of your home, apply now and help us build a brighter, more compassionate future for all patients.