Benefits Specialist

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: Manager of Care Access

FLSA Status: Exempt

Location: Hybrid or Fully Remote

BrightSpan Health is seeking a Benefits Specialist. The Benefits Specialist is responsible for verifying patient insurance coverage and benefits by directly contacting insurance payers to obtain accurate and up-to-date information. This role ensures that insurance eligibility, coverage limitations, co-pays, deductibles, and authorization requirements are clearly determined and documented prior to services being rendered, contributing to a smooth patient experience and efficient claims processing.

What You Can Expect

• Initiate and conduct outbound calls to insurance payers to confirm patient eligibility, plan details, and coverage for specific services, including procedures, diagnostics, and office visits.
• Obtain and verify insurance information, including policy effective dates, plan types, network participation, benefit levels, co-pays, coinsurance, and deductibles.
• Identify and document prior authorization or referral requirements for services scheduled and communicate these to the appropriate internal teams for action.
• Accurately enter insurance details and benefits information into the electronic health record (EHR) or practice management system, ensuring all fields are complete and up-to-date.
• Monitor and track insurance changes, payer updates, and benefit policy revisions, communicating relevant updates to internal stakeholders.
• Resolve discrepancies in insurance information by coordinating with patients, insurance representatives, and internal teams.
• Maintain compliance with HIPAA regulations, organizational standards, and payer-specific requirements when handling patient information and insurance data.
• Support other revenue cycle or patient access activities, including assisting with prior authorizations, as needed.
  
  

What You’ll Need

• High school diploma or equivalent required; associate’s degree or coursework in healthcare administration, medical billing, or related field preferred.
• Minimum of 1–2 years of experience in insurance verification, benefits coordination, or related healthcare administrative work.
• Thorough knowledge of medical insurance plans, terminology, and payer benefit structures (including commercial, Medicaid, and Medicare plans).
• Proficient in the use of EHRs and payer portals, with strong computer and data entry skills.
• Excellent verbal and written communication skills, with the ability to speak professionally with patients, payers, and internal teams.
• Detail-oriented and organized, with the ability to handle multiple tasks and deadlines in a fast-paced environment.
• Knowledge of HIPAA regulations and patient privacy standards.
  
  

It’d be a plus if you had

• Experience with prior authorization or pre-certification processes.
• Familiarity with CPT, ICD-10, and HCPCS codes.
• Bilingual abilities (especially Spanish) a plus.
• Experience in specialty or multi-site healthcare settings.
  
  

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

50,000 - 55,000 USD per year(United States)