Prior Authorization Specialist

Alpaca Health; Philippines; Remote; PHP 17,000 - 22,000; Full time

Job summary

Alpaca Health is hiring a Prior Authorization Specialist to join our Intake Team. This full-time remote role follows North American hours (9am-6pm EST) and focuses on driving authorizations for complex ABA cases with TRICARE expertise.

You will manage escalations, coordinate with families, BCBAs, physicians, and internal teams, and partner with operations to streamline the intake process while maintaining thorough documentation and clear, proactive communication.

Qualifications

• 5+ years of ABA intake experience, with focus on Prior Authorizations.
• Direct TRICARE authorizations experience including ECHO and workflows.
• Highly organized with strong follow-through and reliability.
• Clear, confident communication with families, clinicians, and physicians.
• Able to work in North American business hours remotely.

Responsibilities

• Own the authorization process for complex cases with TRICARE experience.
• Manage escalations from the authorization vendor Silna.
• Coordinate documentation and resolve auth rejections with payers.
• Collaborate with billing and insurance ops to resolve issues quickly.
• Communicate timelines and requirements to families and clinicians.
• Identify bottlenecks and drive process improvements in intake.

Skills

ABA intake

TRICARE authorizations

Communication skills

Organizational skills

Problem solving

Job description

Prior Authorization Specialist

Salary: ₱1,500 - 2,000 monthly

Company: Alpaca Health Job Type: Full Time Philippines

Job Description - 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