AHPC Patient Success Specialist

AHPC Patient Success Specialist

About Thriveworks 

Thriveworks is one of the leading mental healthcare companies in the USA, with over 2,800 employees, and was founded by and is still led by clinicians. Having just launched a new mision to be America’s most valued mental healthcare company, where our teams can fulfill their purpose and do their best work, where clients are treated with warmth and respect, and where communities benefit from access to high-quality care to heal and thrive in life, this company is ready for a new chapter.

About the Job 

The Patient Success Specialist plays a vital role in delivering an exceptional experience at Thriveworks. They are committed to providing outstanding service to both our clients and internal teams, acting as a key point of connection across the organization. With a proactive and solutions-oriented approach, the Patient Success Specialist partners closely with operations leadership, clinical staff, and teams across activation, billing, and claims to ensure every client feels supported and valued. Their dedication helps make Thriveworks a place where both care and collaboration thrive — for those seeking support and those providing it.

Key Responsibilities 

Patient Coordination:

• Respond promptly and professionally to participant inquiries via phone, messaging, or email.

• Conduct timely follow-ups with participants identified as needing additional support.

• Schedule appointments, collect copays, and ensure all patient information and documentation are accurate and current.

• Serve as a liaison between patients, providers, and payers to facilitate timely care and accurate financial processes.

• Collaborate with teammates to meet both individual and team performance goals.

Insurance Verification & Authorization:

• Verify insurance coverage and patient eligibility prior to scheduled services.

• Obtain prior authorizations and pre-certifications as required for specific procedures or services.

• Communicate authorization status, coverage details, and limitations clearly to patients and clinical staff.

Medical Billing & Revenue Cycle Support:

• Support patient billing processes, including charge entry and claims submission.

• Review explanations of benefits (EOBs) and assist in resolving claim discrepancies or denials in coordination with the billing team.

• Collect outstanding balances and assist patients in setting up payment plans when needed.
   

Compliance & Documentation:

• Ensure compliance with HIPAA, insurance regulations, and internal billing policies.

• Accurately document all billing activities, insurance verifications, and patient interactions within the electronic health record (EHR) and billing systems.

Qualifications:

• Education: College education (BA, BS) preferred or equivalent experience in Behavioral Health /Healthcare customer service.

• Experience: Minimum 2–3 years of experience in a medical office or healthcare setting with a focus on insurance, billing, or revenue cycle operations.

• Proficiency in medical billing software and electronic health records (EHR).

• Strong knowledge of insurance verification, authorizations, and payer guidelines (commercial and government plans).

• Empathetic and professional patient interaction.

• Ability to work independently and collaboratively in a fast-paced environment.

• Strong attention to detail and organizational skills.

• Excellent verbal and written communication.

Preferred Qualifications:

• Certified Revenue Cycle Representative (CRCR) or equivalent certification.

• Experience with Cerner and/or MedeAnalytics.

Benefits 

• An amazing team culture

• Healthcare, Dental, Vision, and life insurance benefits

• 401K with 3% employer match

• Paid time off and paid holidays

• Additional coverage options are available, such as Short Term Disability, Long Term Disability, and Group Accident Insurance

• Professional development & advancement opportunities

Successful Thriveworks employees believe in our mission, they embody our core values, which focus on Community, Purpose, Integrity, Access, Quality, and the ability to achieve our goals and work well together. If you fit the bill and belong on our team, apply today!

Physical demands for Thriveworks positions may include being sedentary for long periods. Entering text or data into a computer through a traditional keyboard is also a requirement. 

Thriveworks is an Equal Opportunity Employer. Our people are our most valuable assets. We embrace and encourage differences in age, color, disability, ethnicity, gender identity or expression, national origin, physical and mental ability, race, religion, sexual orientation, veteran status, and other characteristics that make our employees unique. We encourage and welcome diverse candidates to apply for any position you are qualified to bring your unique perspective to our team.

Interested in joining Team Thriveworks? We're thrilled to meet you!

With Job scams becoming more and more frequent, here's how to know you're speaking with a real member of our team:

• Our recruiters and other team members will only email you from thriveworks@myworkday.com or an @thriveworks.com email address.
• Our interviews will take place over Google Meet (not Microsoft Teams or Zoom)
• We will never ask you to purchase or send us equipment.

If you see a scam related to Thriveworks, please report to infosec@thriveworks.com. You can contact employment@thriveworks.com with any questions or concerns.

Thriveworks is an Equal Opportunity Employer. Our people are our most valuable assets. We embrace and encourage differences in age, color, disability, ethnicity, gender identity or expression, national origin, physical and mental ability, race, religion, sexual orientation, veteran status, and other characteristics that make our employees unique. We encourage and welcome diverse candidates to apply for any position you are qualified for to bring your unique perspective to our team.

By clicking Apply, you acknowledge that Thriveworks may contact you regarding your application.