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Role Description

The Financial Services Representative (FSR) plays a critical role in supporting patients through the financial aspects of fertility care. This position is responsible for:

• Insurance verification
• Financial counseling
• Treatment cost estimates
• Payment coordination for fertility services, including diagnostic testing and treatment

The FSR serves as a knowledgeable, compassionate resource for patients navigating complex coverage and payment options.

Key Responsibilities

• Patient Financial Counseling
  • Provide clear, empathetic financial counseling to patients regarding fertility treatment costs, insurance benefits, and out-of-pocket responsibilities
  • Review treatment plans with patients and explain financial obligations prior to the start of care
  • Assist patients with understanding coverage for diagnostic services, infertility treatments, IVF, IUI, fertility preservation, and related medications
• Insurance Verification & Authorization
  • Verify insurance eligibility and benefits for infertility and reproductive services
  • Obtain prior authorizations and referrals as required
  • Communicate with insurance carriers to resolve benefit questions, denials, and coverage discrepancies
• Billing & Payment Coordination
  • Generate accurate treatment estimates/consents and collect payments according to clinic policy
  • Ensure financial clearance prior to services/treatment start dates
  • Complete verification of superbills in a timely manner monitoring accounts for accuracy and completeness
• Collaboration & Documentation
  • Work closely with physicians, nursing staff, and clinical coordinators to align financial and clinical workflows
  • Maintain accurate and timely documentation in the electronic medical record (EMR) and billing systems
  • Support compliance with clinic policies, payer requirements, and HIPAA regulations
• Patient Advocacy & Support
  • Serve as a patient advocate by addressing financial concerns with professionalism, discretion, and sensitivity
  • Respond promptly to patient inquiries via phone, email, and in person
  • Contribute to a positive patient experience during what can be a highly emotional treatment journey

Qualifications

• High school diploma or equivalent
• Minimum of 2 years’ experience in medical billing, insurance verification, or financial counseling
• Strong understanding of insurance plans, benefits, and prior authorization processes
• Excellent communication, organizational, and customer service skills

Preferred Qualifications

• Experience in infertility, reproductive endocrinology, OB/GYN, or specialty medical practice
• Familiarity with ART procedures and fertility benefit structures
• Experience with EMR and practice management systems
• Associate’s or Bachelor’s degree in healthcare administration, business, or related field

Skills & Competencies

• Compassionate and patient-centered approach
• Ability to explain complex financial and insurance information clearly
• Strong attention to detail and accuracy
• Ability to manage multiple priorities in a fast-paced clinical environment
• Professionalism and discretion when handling sensitive information

Work Environment

• Remote home office location