[Hiring] Prior Authorization Specialist @Alpaca Health

Role Description

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.

• 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

Qualifications

• 5+ years of experience in ABA intake, with a specific focus on Prior Authorizations 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

Benefits

• 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