Prior Authorization Specialist

📌 ABOUT ALPACA HEALTH

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.

🎯 Role: Prior Authorizations Specialist

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:

Drive authorizations

• 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

Manage stakeholder communication

• 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

Partner with operations to improve the process

• 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

🧠 Who You Are

• [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

🚀 Why Join

• 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