Member Services Advocate — Benefits & Care Coordination

BrightonOne; United States; Remote; USD 34,000 - 36,000; Full time

Job summary

BrightonOne, a nonprofit social enterprise serving veterans and military-connected families, seeks a Remote USA Contact Center Representative to join US Family Health Plan operations.

You will handle inbound/outbound calls, resolve inquiries on benefits, eligibility, claims, and care coordination, and document interactions in CRM while upholding HIPAA and DoD compliance. The role is full-time, non-exempt, with standard shifts and a $25.00–$26.25 per hour pay range.

Qualifications

• 1+ years of customer service experience, preferably in a call center, healthcare, or insurance environment.
• Experience using computer systems, including CRM platforms and Microsoft Office.
• Knowledge of USFHP or military health benefits preferred.
• Bilingual skills, such as Spanish preferred.

Responsibilities

• Respond to high-volume inbound calls from USFHP members, providers, and caregivers in a professional, empathetic, and timely manner.
• Provide accurate information regarding eligibility and enrollment, benefits and coverage, claims status and billing inquiries, and referrals and authorizations.
• Educate members on plan benefits, navigation of the healthcare system, and available resources.
• Demonstrate a customer-focused and compassionate approach when assisting members and providers.
• Handle sensitive or complex member issues while maintaining professionalism and confidentiality.
• Support care coordination by connecting members with appropriate clinical or case management teams.
• Escalate complex issues or grievances according to established protocols.
• Provide clear and accurate information to help members navigate their healthcare benefits and available resources.
• Document all member and provider interactions clearly and thoroughly in CRM or member systems.

Skills

Verbal communication

Written communication

Customer service excellence

Multitasking

Cultural sensitivity

Education

High school diploma or GED

Associate or Bachelor's degree preferred

Tools

CRM platforms

Microsoft Office

Job description

BrightonOne, a nonprofit social enterprise serving veterans and military-connected families, seeks a Remote USA Contact Center Representative to join US Family Health Plan operations.

You will handle inbound/outbound calls, resolve inquiries on benefits, eligibility, claims, and care coordination, and document interactions in CRM while upholding HIPAA and DoD compliance. The role is full-time, non-exempt, with standard shifts and a $25.00–$26.25 per hour pay range.