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.
BrightSpan Health is seeking a Authorization & Benefits Specialist to support patient access and revenue cycle operations by verifying insurance benefits, securing prior authorizations, and ensuring compliance with payer guidelines. This role plays a critical part in facilitating timely care delivery and accurate claims processing by coordinating with insurance payers, clinical teams, and internal departments.
What You'll Do:
- Verify patient insurance coverage, eligibility, and benefits by contacting insurance payers directly.
- Secure prior authorizations and pre-certifications for medical procedures, diagnostics, treatments, and services.
- Identify and document authorization or referral requirements and communicate them to relevant internal teams.
- Accurately enter and maintain insurance and authorization data in electronic health records (EHR) or practice management systems.
- Monitor and track insurance changes, payer updates, and benefit policy revisions, ensuring timely communication to stakeholders.
- Resolve discrepancies in insurance information by coordinating with patients, payers, and internal teams.
- Maintain organized documentation of all authorization and benefits verification activities in compliance with HIPAA and organizational standards.
- Collaborate with clinical, billing, and administrative staff to align authorizations with scheduled services and claims processing.
- Support departmental goals and assist with special projects or additional duties as assigned.
What You'll Need:
- High school diploma or equivalent required; associate's or bachelor's degree in healthcare administration or related field preferred.
- 2+ years of experience in insurance verification, prior authorization, or related healthcare administrative work.
- Thorough knowledge of insurance plans, payer authorization requirements, and medical terminology.
- Familiarity with commercial, Medicaid, and Medicare benefit structures.
- Proficiency in EHR systems, payer portals, and Microsoft Office.
- Strong attention to detail, organizational skills, and ability to manage multiple tasks in a fast-paced environment.
- Excellent communication and interpersonal skills for professional interaction with payers, patients, and internal teams.
- Knowledge of HIPAA regulations and patient privacy standards.
Preferred Qualifications:
- Experience with CPT, ICD-10, and HCPCS coding.
- Bilingual abilities (especially Spanish).
- Experience in specialty or multi-site healthcare settings.
Why BrightSpan?
- Competitive compensation among industry peers
- 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:48,000 - 52,000 USD per year(Kearny Office - Hybrid)
48,000 - 52,000 USD per year(Lakewood Address)
48,000 - 52,000 USD per year(Remote (United States))
PIaf33c3cae384-37437-38464024
