Alpaca Health
Prior Authorization Specialist
1w ago
1000 USD / yearWorldwideRemote
Responsible for managing and driving the prior authorization process in autism care clinics, collaborating with multiple stakeholders to ensure timely authorizations.
Requirements
- [ REQUIRED] 5+ years of experience in ABA intake, (a specific focus on Prior Authorizations is highly preferred)
- Direct experience with TRICARE authorizations, including ECHO enrollment and prior auth workflows
- You are highly organized and relentless about follow-through — nothing falls through the cracks on your watch
- You communicate clearly and confidently with everyone from frustrated parents to clinical staff to referring physicians
- You are a problem-solver - you identify the issue and fix it
- You are comfortable with ambiguity and can make good judgment calls in real time
- You hold yourself to a high bar while remaining approachable and supportive
Conditions
- The opportunity to materially impact how quickly families access care
- A role where operational excellence directly translates to patient outcomes
- Participate in a critical function at an early-stage, fast-growing company
- Join a team of rockstar performers who have built and started scaling the fastest growing company in the ABA space
Other
- Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.
- We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.
- We've raised over $14M in funding from early-stage investors like Core Innovation Capital, Adverb Ventures, and South Park Commons, and are building for long-term category leadership. More importantly, we're serving hundreds of patients, while growing 30% MoM.
- We are looking to hire a talented ABA Prior Authorizations Specialist to our Intake Team. This role is full-time, remote, and based on North American Hours of 9am- 6pm (EST) Monday to Friday. Your Key Responsibilities will be:
- Own the authorization process for complex cases, with deep expertise in TRICARE (including ECHO enrollment and prior auth workflows)
- Manage escalations from our prior authorizations vendor, Silna
- Support the team in chasing down documentation, resolving auth rejections, and navigating payer requirements
- Partner with billing and insurance ops to resolve issues quickly and cleanly
- Ensure timely, clear communication across all parties: families, BCBAs, referring physicians, and internal teams
- Set and manage expectations with families around timelines, documentation requirements, and next steps
- Step in directly on high-stakes or escalated family situations
- Work with the operations team to identify bottlenecks, inefficiencies, and opportunities across the intake workflow
- Own process improvements from identification through implementation
- Maintain accurate tracking and reporting across systems