Essential Duties & Responsibilities
Insurance Review Coordination
- Coordinate and manage insurance reviews for all gestational carrier candidates.
- Submit insurance policies and supporting documentation to ART Risk or other approved insurance review vendors.
- Track insurance review requests from submission through completion.
- Review insurance determinations and communicate findings and recommendations to Journey Coordinators and internal stakeholders.
- Maintain expected turnaround times by proactively following up with insurance vendors.
- Ensure all required insurance reviews are completed prior to medical clearance.
Insurance Planning & Coverage Coordination
- Coordinate with ART Risk and other approved insurance vendors to facilitate insurance reviews for all gestational carriers.
- Monitor the progress of insurance reviews and proactively follow up to ensure timely completion.
- Review completed insurance review reports for accuracy, completeness, and any required follow-up items.
- Communicate insurance review outcomes and recommendations to Journey Coordinators and other internal stakeholders.
- Coordinate the appropriate insurance pathway based on vendor recommendations, including:
- Existing surrogate-friendly insurance
- ACA Marketplace enrollment during Open Enrollment
- Lloyd's or other maternity insurance policies when applicable
- Partner with insurance vendors to resolve questions, obtain clarification, or address incomplete or conflicting information.
ACA Marketplace & Open Enrollment Coordination
- Track annual Open Enrollment periods for gestational carriers requiring new insurance coverage.
- Coordinate ACA Marketplace enrollment timelines.
- Communicate enrollment deadlines with Coordinators and Managers
- Attended ArtRisk Webinars.
- Assist with collecting required enrollment documentation.
- Monitor policy effective dates and activation.
Maternity Insurance Coordination
When traditional insurance is unavailable or does not provide surrogate coverage:
- Coordinate the procurement of Lloyd's or other approved interim maternity insurance policies (e.g., NLA).
- Collect and submit all required documentation to the appropriate insurance vendor.
- Track policy applications, approvals, and issuance through completion.
- Monitor policy timelines and effective dates to ensure coverage aligns with the gestational carrier's treatment plan.
- Coordinate with ART Risk upon confirmation of pregnancy (heartbeat confirmation) to finalize and activate the interim maternity insurance policy.
- Obtain the finalized monthly premium and deductible information once the policy has been activated.
Premium & Invoice Management
- Review all insurance-related invoices for accuracy.
- Coordinate premium payment requests with the Finance Department.
- Track premium due dates.
- Verify premiums have been paid timely.
- Maintain documentation of all insurance payments.
- Prevent lapses in insurance coverage due to missed payments.
Insurance Timeline Management
Maintain and monitor tracking for:
- Insurance review requests
- Insurance review completion dates
- Open Enrollment opportunities
- ACA enrollment timelines
- Policy effective dates
- Premium due dates
- Invoice payments
- Coverage activation dates
- Medical clearance deadlines
- Embryo transfer readiness
- Policy expiration dates
- Insurance renewal requirements
Proactively identify upcoming deadlines that could impact a client's journey and communicate potential risks to the appropriate team members.
Vendor & Carrier Management
Serve as the primary liaison between Surrogacy Is and insurance vendors, including but not limited to:
- ART Risk
- IFI
- Additional insurance partners as assigned
Develop and maintain professional relationships while ensuring timely communication and issue resolution.
Documentation & Recordkeeping
- Maintain complete insurance documentation within each client record.
- Ensure all insurance files are organized, accurate, and audit-ready.
- Upload insurance documentation into internal systems.
- Maintain insurance tracking through internal, proprietary Journey Management system
- Document all insurance communications, determinations, approvals, and policy changes.
Process Improvement
- Participate in the development of and maintain Standard Operating Procedures (SOPs) related to insurance processes.
- Identify opportunities to improve insurance workflows and reduce delays.
- Create and maintain tracking tools and reporting dashboards.
- Assist with training Journey Coordinators on insurance processes and best practices.
- Recommend process improvements that enhance efficiency and improve the client experience.
Qualifications
Required
- Associate's degree or equivalent professional experience.
- Two (2) or more years of experience in insurance coordination, healthcare administration, case management, fertility, surrogacy, or a related field.
- Exceptional organizational and time management skills.
- Strong attention to detail and accuracy.
- Experience working within the surrogacy or fertility industry.
- Knowledge of surrogate-friendly insurance policies and maternity coverage.
- Experience working with ART Risk or similar insurance review organizations.
- Familiarity with ACA Marketplace enrollment.
- Experience coordinating insurance vendors and carriers.
Perks & Benefits
- 401K with 100% company match up to 4% of pay
- PTO/Sick time
- 12 paid holidays
- 1 week paid rest break for winter holidays (in addition to PTO and holidays)
- Company retreats and ongoing education opportunities