Integrated Care for Greater Health, Inc. (ICGH)

Authorization Specialist

• 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

Explore Behavioral Health Authorization and Credentialing Specialist at Integrated Care for Greater…. Review requirements and application details.

Behavioral Health Authorization and Credentialing Specialist

Billing Specialist

• Prepare, submit, and manage claims for behavioral health services to Medicaid, Medicare, and commercial insurance payers
• Verify patient insurance eligibility, benefits, authorizations, and coverage requirements
• Ensure services are billed accurately using appropriate CPT, HCPCS, ICD-10, and place-of-service codes
• Review clinical documentation to support prior authorization submissions and ensure compliance with payer authorization guidelines
• Post payments, adjustments, and denials accurately in the billing system
• Identify, research, and resolve claim denials, underpayments, and rejections
• Submit appeals and corrected claims within payer deadlines
• Monitor accounts receivable and follow up on outstanding claims to ensure timely reimbursement
• Communicate with clinicians, supervisors, and insurance representatives regarding billing issues
• Ensure compliance with payer requirements, state and federal regulations, and organizational policies while maximizing reimbursement and minimizing denials

Explore Behavioral Health Outpatient Billing Specialist at Integrated Care for Greater…. Review requirements and application details.

Open roles

Behavioral Health Authorization and Credentialing Specialist

Behavioral Health Outpatient Billing Specialist