Remote Member Support Specialist - Healthcare Appeals

Brighton Health Plan Solutions, LLC; Chapel Hill (NC); Remote; USD 36,000 - 48,000; Full time

Job summary

Brighton Health Plan Solutions, LLC is seeking a Customer Service Representative for a remote role. The position focuses on assisting members, physicians, hospitals, and other providers with benefits, eligibility, and appeals.

Shifts span Monday to Friday between 8 AM–5:30 PM EST, with a focus on high-quality member support. The role emphasizes accurate data handling, empathetic service, and collaboration across teams to improve patient experience.

Qualifications

• Experience in a high-volume call center handling member benefits, eligibility, and appeals.
• Experience with medical specialties, complaints and appeals in healthcare.
• Experience in a physician’s office, group practice, clinic, or hospital setting.

Responsibilities

• Handle inbound calls from members, providers, and others.
• Address customer needs empathetically and provide clear information.
• Coordinate with internal teams to ensure first contact resolution when possible.
• Update customer files accurately and communicate effectively across departments.
• Educate callers and verify their understanding of benefits and processes.
• Support projects and process improvements as directed by management.

Skills

Call center experience

Healthcare knowledge

Medical office experience

Education

High school diploma

Tools

Microsoft Office

Job description

Brighton Health Plan Solutions, LLC is seeking a Customer Service Representative for a remote role. The position focuses on assisting members, physicians, hospitals, and other providers with benefits, eligibility, and appeals.

Shifts span Monday to Friday between 8 AM–5:30 PM EST, with a focus on high-quality member support. The role emphasizes accurate data handling, empathetic service, and collaboration across teams to improve patient experience.