Remote Healthcare Member Support Specialist

Brighton Health Plan Solutions; United States; Remote; USD 42,000 - 54,000; Full time

Job summary

Brighton Health Plan Solutions, LLC is seeking a Customer Service Representative to assist members, physicians, hospitals, and providers with benefits, eligibility, and appeals. The role is remote and supports various shifts Monday to Friday 9AM-5PM EST.

You will handle inbound calls, address concerns, update files, and contribute to customer satisfaction. Previous call center experience in healthcare settings is preferred, with HIPAA knowledge and proficiency in Microsoft Office.

Qualifications

• Experience in a high-volume call center.
• Experience with medical specialties, complaints and appeals.
• Previous experience in a physician’s office, group practice, clinic or hospital-based practices.

Responsibilities

• Handle inbound calls from members, medical providers, and others.
• Listen to and address customer needs and concerns empathetically.
• Answer questions about network participation.
• Ensure first contact resolution when possible.
• Update customer files and communicate with teams.
• Transfer misdirected requests and offer solutions to non-routine issues.
• Contribute to customer satisfaction and business improvement.
• Collaborate with other team members.
• Adapt responses to caller understanding.
• Educate callers and validate their understanding.
• Support projects and other departments as directed by management.

Skills

Call center

HIPAA knowledge

Customer service

Healthcare eligibility

Communication skills

Problem solving

Education

High School diploma with some college

Tools

Microsoft Office

Job description

Brighton Health Plan Solutions, LLC is seeking a Customer Service Representative to assist members, physicians, hospitals, and providers with benefits, eligibility, and appeals. The role is remote and supports various shifts Monday to Friday 9AM-5PM EST.

You will handle inbound calls, address concerns, update files, and contribute to customer satisfaction. Previous call center experience in healthcare settings is preferred, with HIPAA knowledge and proficiency in Microsoft Office.