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

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Source: Alpaca Health job board (Ashby).

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