Senior Administrative Data Entry Specialist – Healthcare Utilization Review & Medical Claims Management, Clinical Data Integrity & Analytics Expert – Remote, Competitive Compensation, Career Growth at brighthush
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- About brighthush
brighthush is a trailblazer in the evolving healthcare landscape, seamlessly blending cutting‑edge technology with evidence‑based care to deliver patient‑centric solutions across hospitals, outpatient centers, and community programs nationwide. Our mission is simple yet powerful: to elevate health outcomes through meticulous data stewardship, compassionate service, and relentless innovation. Every team member at brighthush is empowered to grow—professionally and personally—while making a tangible difference in the lives of the patients we serve.
Why brighthush?
When you join brighthush, you become part of a culture that values precision, empathy, and forward‑thinking. We believe that the best healthcare outcomes start with the best data, and we are committed to ensuring that every data point is accurate, secure, and compliant. Below are just a few reasons why top talent chooses to build their careers with us:
Impactful Work:
Your expertise will directly shape the accuracy and efficiency of critical healthcare data, ensuring patients receive timely, appropriate care.
Remote Flexibility:
Work from anywhere while staying connected to a vibrant, supportive team.
Career Advancement:
Structured career paths, mentorship programs, and industry‑leading training keep you moving forward.
Competitive Compensation:
Comprehensive benefits—including medical, dental, vision, 401(k) matching, and generous paid time off—recognize your value.
Inclusive Culture:
Diversity, equity, and inclusion are at the heart of everything we do; your ideas and perspectives are not only welcomed but celebrated.
Innovation‑Driven Environment:
Work alongside experts who are constantly exploring new technologies and methodologies to improve patient care.
Role Overview
As a Senior Administrative Data Entry Specialist, you will be the linchpin of our Utilization Review and Peer Review Department. You will manage Workers’ Compensation, Group Health, and Disability cases, ensuring that every data point is accurate, secure, and compliant with all regulatory standards. Your meticulous attention to detail, strong organizational skills, and deep understanding of complex healthcare systems will keep our data ecosystem robust and reliable.
Key Responsibilities
Data Management:
Upload referral forms, enter new referral data, and maintain demographic information in our secure claims and clinical management systems.
Verification & Coordination:
Verify client requirements, coordinate with nurses, physicians, and clients to gather necessary documentation, and ensure all data is complete before proceeding.
Case Assignment & Monitoring:
Assign new referrals, triage cases for utilization review, and monitor ongoing cases to ensure timely completion of review procedures.
Communication:
Respond to inquiries from providers, claims adjusters, patients, and internal stakeholders; place outbound calls to schedule and facilitate review discussions.
Documentation & Reporting:
Distribute incoming and outgoing correspondence, faxes, and mail; upload review documents into the paperless system; generate and run reports as required.
Quality Assurance:
Participate in audits, accreditation processes, and other quality assurance functions to uphold the highest standards of data integrity.
Collaboration:
Support other units as needed, attend training sessions, and contribute to continuous improvement initiatives.
Compliance:
Perform all duties in accordance with company policies, procedures, and applicable laws and regulations.
What You'll Bring
- High school diploma or equivalent (AA or BA preferred).
- Excellent customer service orientation with strong verbal and written communication skills.
- Proficiency in Microsoft Office Suite, especially Excel, and experience with online database systems.
- Strong keyboarding skills and the ability to work independently while managing multiple priorities.
- Demonstrated ability to analyze information, solve problems, and make sound decisions.
- High level of organization, time‑management, and attention to detail.
- Capability to handle sensitive and confidential information with utmost professionalism.
- Ability to work remotely, maintain a reliable internet connection, and adhere to scheduled hours (9 am – 6 pm PST).
Preferred Qualifications
- Previous experience in the medical field, healthcare, insurance claims, Workers’ Compensation, managed care, medical management, or utilizati
