Behavioral Health Authorization and Credentialing Specialist

About Us

Integrated Care for Greater Health (ICGH) is a recovery-focused organization that grew from Hickory, North Carolina into a growing continuum of services designed to help people build lives in which recovery can last. ICGH has grown by responding to barriers people can encounter in recovery, including distance, medication access, transportation, housing, justice transitions, and disconnected levels of care.

Today, ICGH connects community clinics, inpatient and mobile integrated care, statewide low-barrier telehealth, pharmacy and medication access, peer support, recovery housing, transportation, and care navigation. Our guiding philosophy is “Recovery—not treatment.” We believe in building a connected continuum that supports people in recovery wherever and however they access services.

Job Function

The Behavioral Health Authorization & Credentialing Specialist manages the authorization and provider credentialing processes for ICGH. This position works with insurance payers and internal teams to obtain required service authorizations, coordinate provider enrollment and credentialing, maintain accurate records, and monitor authorization and credentialing status. The Specialist serves as a primary point of coordination for authorization and credentialing-related matters, helping prevent authorization and enrollment-related delays while supporting continuity of services, accurate billing, and reimbursement.

Essential Functions

• 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 the 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 the 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.

Non-Essential Functions

• 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.

Knowledge, Skills, and Abilities

• 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.

What Success Looks Like in the Role

Success in this role means keeping authorizations accurate, current, and in place throughout the individual’s services, while ensuring providers are appropriately credentialed and enrolled with applicable insurance payers. The successful Specialist stays ahead of authorization deadlines, credentialing requirements, and enrollment timelines; follows up promptly with payers and internal teams; communicates issues clearly; and works proactively to prevent authorization or credentialing delays from impacting services, billing, or reimbursement.