Clinic Authorization Specialist

Member Services New York, New York Remote, United States


We are looking for a detail-oriented Authorization Specialist to handle daily authorization requests for in-network clinics. The position entails answering a high volume of phone calls and emails. The successful candidate will be able to ensure an elevated level of customer service, maintain positive relationships within the network and maximize productivity by reviewing accuracy for data processing. The Authorization Specialist must be able to operate in a fast-paced environment, manage difficult conversations, be thoughtful, resourceful, collaborative, and customer focused. 

What you’ll do…  

  • Manage a high volume of provider calls and emails – time management and efficiency are critical! 
  • Be passionate about providing the best possible provider and member experience at all times  
  • Review and analyze complex fertility related authorization requests by navigating multiple systems and platforms and accurately capture the data/information for processing (e.g. verify prior authorizations, applicable benefits)  
  • Communicate with providers regarding authorizations or required additional information for accurate authorizations 
  • Interpret and enforce clinic contracts as it relates to covered services and authorizations; be a fearless and persuasive speaker in encouraging partner providers to maintain compliance with best practices and contractual guidelines; be able to overcome objections and ensure authorizations align with contractual guidelines 
  • Be flexible and to adapt with evolving business needs  

About you…

  • Prior experience required in a health care environment—knowledge of the fertility industry is preferred 
  • Undergraduate degree  
  • Prior experience using Microsoft excel and outlook, and Salesforce knowledge preferred 
  • Ability to manage multiple priorities including understanding various insurance products and levels of benefit within each product. 
  • Comfortable in an environment with data-driven goals with monthly performance feedback 
  • Flexible and able to navigate change 
  • Ability to manage difficult conversations  
  • Knowledge of CPT, HCPCS, AND ICD-10 codes and understanding of medical terminology strongly preferred 
  • Ability to work independently and demonstrate good judgment 
  • Excellent interpersonal skills - ability to communicate accurately and effectively with internal and external stakeholders 
  • Highly organized, quick learner, with ability to multitask and prioritize work effectively 


About Progyny:   

Progyny is a leading fertility benefits management company in the US. We are redefining fertility and family building benefits, proving that a comprehensive and inclusive fertility solution can simultaneously benefit employers, patients, and physicians. Our benefits solution empowers patients with education and guidance from a dedicated Patient Care Advocate (PCA), provides access to a premier network of fertility specialists using the latest science and technologies, reduces healthcare costs for the nation’s leading employers, and drives optimal clinical outcomes. We envision a world where anyone who wants to have a child can do so.  


Our mission is to make any member’s dream of parenthood come true through a healthy, timely, and supported fertility and family building journey.  


Come join a company that’s been recognized by Modern Healthcare as one of the Best Places to Work in Healthcare.  


Our perks: 

  • Family friendly benefits: Paid maternity and paternity, fertility benefits (including egg freezing and IVF), emergency childcare program, parent’s group  
  • Health, dental, vision and life insurance options for employees and family  
  • Paid vacation and summer flex time  
  • Company equity  
  • Bonus program  
  • 401K Match  
  • Company social events  
  • Flex days (3 days a week in the office) for positions located at NY office 
In compliance with New York City's Wage Transparency Law, the annual wage range for NYC-based applicants is: $25.00/hour - $35.00/hour. Progyny offers a total compensation package comprised of base salary, cash bonus, and equity.

Progyny is an Equal Opportunity Employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce.