Authorization Specialist

Job Description

Job Description

Description:

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 support lasting recovery. We connect community clinics, inpatient and mobile integrated care, telehealth, pharmacy and medication access, peer support, recovery housing, transportation, and care navigation.

Our guiding philosophy is "Recovery—not treatment." We believe in creating connected, accessible services that support individuals wherever they are in their recovery journey.

The Authorization Specialist is responsible for coordinating and managing service authorizations across applicable insurance plans. This position ensures authorization requirements are identified, requests are submitted accurately and timely, and approved services remain current to support continuity of care and reimbursement. The Authorization Specialist works closely with internal clinical, operational, and billing teams, as well as insurance payers, to resolve authorization issues, prevent service interruptions, and maintain compliance with payer requirements.

• Obtain and maintain required service authorizations across applicable insurance plans.
• Verify authorization requirements, covered services, approved units, service limitations, and payer-specific guidelines.
• Gather supporting clinical documentation and submit initial and continued authorization requests within required payer timeframes.
• Monitor authorization statuses, approved units, service utilization, and expiration dates to prevent gaps in coverage.
• Communicate with insurance payers and internal teams regarding authorization requests, approvals, denials, pending requests, and outstanding documentation requirements.
• Research authorization issues, coordinate necessary documentation, and follow appeals through resolution.
• Track authorization deadlines and proactively communicate upcoming expirations or additional authorization needs to the appropriate teams.
• Review authorization information for accuracy and ensure approved services align with payer requirements.
• Identify and address authorization issues that may impact service delivery, billing, or reimbursement.
• Maintain accurate authorization records and tracking systems to support operational needs, audits, and reporting.
• Collaborate with clinical and administrative teams to obtain necessary information and documentation for authorization submissions.
• Stay informed of changes in insurance authorization requirements, payer guidelines, and applicable processes.
• Identify opportunities to improve authorization workflows, tracking, communication, and overall efficiency.

• High school diploma or equivalent.
• Minimum of 1–2 years of healthcare administrative, insurance authorization, medical billing, or related experience.
• Familiarity with insurance authorization processes and payer requirements.
• Basic understanding of insurance plans, covered services, medical necessity, and authorization requirements.
• Strong organizational skills and attention to detail.
• Ability to manage multiple responsibilities, deadlines, and priorities.
• Proficiency in Microsoft Office, particularly Excel and Word.

• Experience with service authorizations in healthcare or behavioral health settings.
• Familiarity with North Carolina Medicaid, including Medicaid Managed Care Organization (MCO) plans.
• Experience working with Medicare and commercial insurance payers.
• Experience submitting initial, continued stay, and concurrent authorization requests.
• Familiarity with electronic health record (EHR) systems and authorization tracking tools.
• Experience communicating with insurance representatives to resolve authorization issues and follow up on pending requests.

• Strong organizational and time-management skills.
• Excellent written and verbal communication.
• Strong follow-up, problem-solving, and critical-thinking skills.
• Ability to communicate professionally with insurance representatives and internal teams.
• Ability to work independently while collaborating effectively with others.
• Professionalism and discretion when handling confidential information.
• Ability to manage time-sensitive requests and meet payer-specific deadlines.
• Ability to adapt to changing payer requirements, authorization guidelines, and processes.