Clinic & Billing Specialist

Progyny, Inc.•New York, NY

18h•Hybrid

About The Position

Thank you for considering Progyny! We’re looking for a Clinic & Billing Specialist to support daily interactions with our members and in-network clinics. In this role, you’ll help create and issue authorizations, resolve billing inquiries, and ensure a smooth, accurate billing experience. You’ll manage a high volume of calls and emails, review and resolve billing issues and denied claims, and partner with providers to support accurate claims processing. The ideal candidate is adaptable, communicates clearly and respectfully, and takes a thoughtful, solutions-oriented approach to their work.

Requirements

1–3 years of experience in a health insurance or healthcare billing environment (fertility experience preferred)
Experience with Microsoft Excel required; familiarity with CRM tools (Salesforce experience is a plus)
Ability to manage multiple priorities and navigate various insurance products and benefit structures
Comfortable working in a metrics-driven environment with regular performance feedback
Ability to handle complex conversations in a professional and respectful manner
Knowledge of CPT, HCPCS, and ICD-10 codes and medical terminology preferred
Ability to work independently and use sound judgment
Strong communication and interpersonal skills with a wide range of stakeholders
Highly organized, detail-oriented, and able to manage multiple tasks effectively
Candidates must be based in the United States.
Candidates must be authorized to work in United States without the need for sponsorship, now or in the future.

Nice To Haves

Bachelor’s degree preferred, or equivalent combination of education and relevant experience
fertility experience preferred
familiarity with CRM tools (Salesforce experience is a plus)
Knowledge of CPT, HCPCS, and ICD-10 codes and medical terminology preferred

Responsibilities

Manage a high volume of inbound calls and emails from members and providers
Build strong relationships by delivering high-quality, respectful service and resolving billing issues effectively
Review, research, and analyze complex fertility-related claims across multiple systems, ensuring accurate data capture and processing (e.g., pricing, prior authorizations, benefits verification)
Communicate with providers to resolve claim discrepancies and obtain required information for payment
Explain financial responsibility (including deductibles, coinsurance, and out-of-pocket maximums) in a clear and understandable way
Interpret and apply clinic contract terms related to covered services and authorizations
Maintain accuracy and productivity standards in claims review and processing
Adapt to evolving business needs and priorities

Benefits

Health, dental, vision and life insurance options for employees and family
Free in-person, virtual and text-based mental health and wellness support
Paid time off, including vacation, sick leave, personal days and summer flex time
Company equity
Bonus program
401(k) plan with company match
Access to on-demand legal and financial advice
Learning and development programs to help you grow professionally and a mentorship program
Company social events to include annual volunteer day and donation matching
Family friendly benefits: Paid family and parental leave, preconception, fertility and family building benefits (including egg freezing, IVF, and adoption support), family and pet care fund, and Parents’ Employee Affiliation Group
Menopause and midlife care
Flex days (3 days a week in the office) and onsite meals and snacks for employees reporting into our NY office