Customer Service Rep, Casualty at Brighton Health Plan Solutions in Chapel Hill, NC
- Company: Brighton Health Plan Solutions
- Location: Chapel Hill, NC
- Posted: Sep 17, 2026
- Type: Full-time
- Experience: 4+ years
Overview
The Customer Service Representative assists members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals. The Customer Service Representatives must be able to work in various shifts Monday to Friday between the hours of 9AM – 5PM EST.
Job description
- The Customer Service Representative assists members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals. The Customer Service Representatives must be able to work in various shifts Monday to Friday between the hours of 9AM – 5PM EST.
- This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities and activities may change, or new ones may be assigned at any time with or without notice.
- *This is a Remote Role
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 effectively 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.
Requirements
- The successful candidate will have experience in a high-volume call center, experience with medical specialties, complaints and appeals and call center responsibilities. Previous experience in a physician’s office, group practice, clinic or hospital-based practices.
- High School diploma with some college or business school education preferred.
- Basic computer operations knowledge.
- Intermediate proficiency in Microsoft Office (Word, Excel, Access, PowerPoint, Outlook).
- Strong time management skills.
- General knowledge of HIPAA Confidentiality laws.
- Quick learner with ability to grasp managed care procedures.
- Detail-oriented and dependable.
- Effective listening and responding skills.
- Flexible and adaptable to changes, with conceptual thinking.
- Strong problem-solving abilities.
- Excellent attendance and punctuality.
- Comfortable performing tasks at a computer/telephone station.
- Effective communication through various channels, including email, chat, and voice.
Skills
Required
- Basic computer operations knowledge
- Strong time management skills
- Detail-oriented and dependable
- Strong problem-solving abilities
- Excellent attendance and punctuality
About Brighton Health Plan Solutions
At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions. Come be a part of the Brightest Ideas in Healthcare™.