Remote Prior Authorization Lead – ABA Payor Solutions

Health Data Innovations, Inc.; New York (NY); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Impact on patient outcomes

Rapid career growth

Startup environment

Tech-first platform

Job summary

Alpaca Health, a remote-friendly US-based health innovator, is seeking a Prior Authorizations Manager to lead ABA intake and authorization workflows for multiple payors. This full-time position is remote and requires deep knowledge of pre-certification processes and payer requirements within autism care.

You will collaborate with providers, patients, and payors to resolve complex cases, streamline documentation, and improve authorization outcomes across regions, driving efficiency and

Qualifications

• 5+ years of experience in ABA intake with a focus on Prior Authorizations or Insurance Certification.
• Strong understanding of ABA pre-certification for Tricare East, Medicaid MCOs, BCBS State plans, Aetna, and/or Cigna.
• Highly organized with relentless follow-through and attention to detail.
• Ability to read complex clinical documents, payer feedback, and EHR data related to prior authorizations.
• Excellent written and verbal communication with families, clinicians, and payor contacts.
• Problem-solving mindset with ability to fix issues quickly.
• Comfortable with ambiguity and making sound judgments in real time.
• Maintain high standards while being approachable and supportive.

Responsibilities

• Coordinate with Prior Authorizations vendor to resolve complex issues with providers, patients, and payors.
• Serve as the in-house expert for all prior authorizations and pre-certification requirements for regions/payors.
• Support the team in gathering documentation, resolving auth rejections, and navigating payer requirements.
• Identify bottlenecks across intake workflow with operations.
• Develop training materials for offshore team members to resolve daily authorization issues.
• Own authorization outcomes and KPIs for your region/payors.

Skills

ABA intake

Prior Authorizations

Insurance Certification

Organized

Attention to detail

Clear communication

Problem-solving

Ambiguity tolerance

Team collaboration

Job description

Alpaca Health, a remote-friendly US-based health innovator, is seeking a Prior Authorizations Manager to lead ABA intake and authorization workflows for multiple payors. This full-time position is remote and requires deep knowledge of pre-certification processes and payer requirements within autism care.

You will collaborate with providers, patients, and payors to resolve complex cases, streamline documentation, and improve authorization outcomes across regions, driving efficiency and