Prior Authorization Specialist

Alpaca Health; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Alpaca Health is seeking an experienced ABA Prior Authorizations Specialist to join our Intake Team. This full-time, remote role operates on North American hours (9am–6pm EST) Monday to Friday, collaborating with families, BCBAs, and clinical staff to drive authorizations and streamline payer requirements.

You will own the authorization process for complex TRICARE cases, coordinate with our vendor Silna, and help improve intake workflows while maintaining clear, proactive communication across

Qualifications

• 5+ years of ABA intake experience.
• Direct experience with TRICARE authorizations, including ECHO enrollment and prior auth workflows.
• Highly organized and relentless about follow-through.
• Clear and confident communication with families, clinicians, and physicians.
• Adaptive and capable of making good judgments in real-time.

Responsibilities

• Drive authorizations for complex cases, with deep expertise in TRICARE workflows.
• Manage escalations from the prior authorizations vendor, Silna.
• Support documentation gathering, resolve auth rejections, and navigate payer requirements.
• Partner with billing and insurance ops to resolve issues quickly and cleanly.
• Ensure timely, clear communication across families, providers, and internal teams.

Skills

Prior authorizations

TRICARE authorizations

Communication

Organization

Problem-solving

Job description

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