Clinic & Billing Specialist

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. What you’ll do 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 About you 1-3 years of experience in a health insurance or healthcare billing environment (fertility experience preferred) Bachelor's degree preferred, or equivalent combination of education and relevant experience 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 Please note: This is not a digital nomad or remote international position; candidates must be based in the United States. Progyny is unable to provide visa sponsorship for this position. Candidates must be authorized to work in United States without the need for sponsorship, now or in the future. In compliance with New York City's Wage Transparency Law, the hourly salary range for NYC‑based applicants is $26.44/hour - $31.25/hour . There are a variety of factors that go into determining a salary range, including but not limited to external market benchmark data, geographic location, and years of experience sought/required. Progyny offers a total compensation package comprised of base salary, cash bonus, and equity. Progyny is proud to be an Equal Opportunity and affirmative action employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, marital status, pregnancy or related condition, status as a protected veteran, criminal history consistent with legal requirements or any other basis protected by law. If you are an individual with a disability and need assistance or an accommodation during the recruiting process, please send an e‑mail to View email address on click.appcast.io. #J-18808-Ljbffr