Behavioral Health Authorization and Credentialing Specialist

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🔥 1 minute ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 12%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Integrated Care for Greater Health, Inc. (ICGH)

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2006

🏥 Healthcare

🌍 Social Impact

Healthcare • Social Impact

Integrated Care for Greater Health, Inc. (ICGH) is a North Carolina-based provider of comprehensive behavioral health and substance-use recovery services. ICGH operates a continuum of care including 24-hour inpatient and stabilization services, withdrawal management, residential treatment, outpatient behavioral health and psychiatry, medication for opioid use disorder (MOUD/MAT), pharmacy services, statewide telehealth (Bupe. Online), mobile integrated care, peer support, recovery housing, and justice- and school-based programs. ICGH runs multiple community clinics and a residential campus across North Carolina and emphasizes connections between clinical care, peer services, housing, transportation, and community partnerships to support long-term recovery.

📋 Description

• Obtain and maintain required authorizations for ICGH services • Submit initial and continued authorization requests within required payer timeframes • Communicate with insurance payers regarding authorization requests, approvals, denials, and requirements • Obtain and review documentation needed to support authorization requests • Maintain accurate authorization information in the EHR and authorization tracking system • Monitor authorization status, approved units, and expiration dates • Coordinate with clinical and operational teams to obtain information needed for authorizations and continued reviews • Communicate authorization approvals, limitations, denials, and issues to appropriate teams • Track authorization appeals through resolution • Identify and address authorization issues that may impact services or billing • Coordinate provider credentialing and enrollment with insurance payers • Prepare, submit, and track initial provider credentialing and enrollment applications • Monitor credentialing applications, follow up with payers, and address outstanding requests for information or documentation • Maintain provider credentialing records, including application status, effective dates, recredentialing deadlines, and enrollment requirements • Monitor provider recredentialing and payer revalidation requirements to ensure timely completion • Coordinate with providers and internal teams to obtain required credentialing documentation and maintain accurate provider information • Communicate provider enrollment approvals, effective dates, and outstanding credentialing issues to appropriate teams • Identify and address credentialing or enrollment issues that may impact billing, reimbursement, or provider participation • Maintain complete and accurate authorization and credentialing records • Participate in authorization and credentialing audits and quality improvement activities • Participate in department meetings and team initiatives • Assist with updates to authorization and credentialing workflows, tracking tools, and procedures • Support quality improvement efforts related to authorization and credentialing processes • Perform other related duties as assigned

🎯 Requirements

• Knowledge of behavioral health services and insurance authorization processes • Familiarity with provider credentialing and insurance enrollment processes preferred • Knowledge of payer requirements and authorization procedures • Strong organizational and time-management skills • Strong attention to detail and accuracy • Effective written and verbal communication skills • Ability to manage multiple authorizations, credentialing applications, deadlines, and priorities • Ability to communicate effectively with insurance payers, providers, and internal teams • Ability to maintain accurate and confidential records • Ability to identify authorization and credentialing issues and follow through to resolution • Ability to work independently and collaboratively • Ability to adapt to changing payer requirements and processes

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