Why BrightSpan?
- At BrightSpan Health, our mission is to bridge the gap between clinical care and operational clarity—empowering providers through expert revenue cycle solutions that ease administrative burdens, restore peace of mind, and make room for what matters most: their clients. We're not just managing claims—we're shaping futures for providers, their patients and the communities they serve.
- We envision a healthcare system where providers are free to lead with compassion, where financial clarity supports clinical excellence, and where every provider organization has the tools to thrive—behind the scenes and beyond. BrightSpan exists to illuminate the path forward, one bridge at a time.
Department: Care Access
Reports To: Head of Care Access
FLSA Status: Exempt
Location: Hybrid or Fully Remote
BrightSpan Health is seeking a Manager of Authorization & Benefits. This role oversees and coordinates the end-to-end prior authorization process, ensuring timely and accurate submission, follow-up, and documentation of all requests. This role is responsible for maintaining compliance with payor requirements, optimizing workflow efficiency, and supporting clinical operations through effective authorization management.
What you"ll do
- Ensure the team consistently submits complete and accurate authorization and pre-certification requests, reducing delays and denials in service delivery.
- Oversee and manage the prior authorization process by ensuring timely and accurate submission of requests to payors for services requiring approval.
- Coordinate and supervise the verification of patient insurance coverage, including eligibility, benefit information, and authorization requirements across various payors.
- Monitor, track, and follow up on all pending authorization requests, ensuring resolution within payor-specific timelines.
- Maintain accurate and thorough documentation of all authorization activities, in compliance with organizational standards and regulatory guidelines.
- Stay informed and disseminate updates to the team on changes to payor authorization policies, processes, and payer-specific nuances.
- Develop and implement workflows, training, and performance standards for authorization staff to ensure departmental efficiency and compliance.
- Collaborate with clinical and administrative teams to streamline the authorization process and support continuity of care.
- Analyze and report on departmental metrics, identifying areas for improvement and implementing process enhancements.
- Perform other related duties as assigned to support departmental and organizational goals.
What you"ll need
- Bachelor's degree in healthcare administration, business, or a related field or equivalent experience required.
- 3–5 years of experience in prior authorizations, medical billing, or insurance verification, with at least 1–2 years in a supervisory or management role.
- Strong knowledge of payor requirements, insurance plans, and prior authorization processes across various healthcare services.
- Proficient in using electronic health records (EHR) and authorization portals, with excellent documentation and data tracking skills.
- Exceptional communication, leadership, and problem-solving abilities, with a focus on process improvement and team development.
- Ability to analyze metrics and reports to identify trends, gaps, and opportunities for efficiency and compliance improvements.
Why BrightSpan?
- Competitive compensation among our industry competitors;
- Medical, dental and vision insurance;
- FSA & HSA plans available;
- Paid time off and holidays;
- Opportunities for professional and career development in a growing organization;
The pay range for this role is:75,000 - 85,000 USD per year(Lakewood Address)
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