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Alpaca Health logo

Prior Authorization Specialist

Posted about 2 months ago

RemoteUnited States (Remote)

📌 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.

This role is full-time. We’re looking for candidates based in NYC or open to relocating who are open to 5 days a week in the office.

🎯 Role: Prior Authorizations Specialist

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

đź§  Who You Are

  • 5+ years of experience in ABA intake, care coordination, or clinic operations — you know this world deeply

  • Direct experience with TRICARE authorizations, including ECHO enrollment and prior auth workflows

  • Proven track record managing a team in a healthcare or clinical operations setting

  • 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 who doesn't wait for permission — you identify the issue and fix it

  • You are comfortable with ambiguity and can make good judgment calls in real time

  • You hold your team to a high bar while remaining approachable and supportive

🚀 Why Join

  • Direct line to company leadership — you report to the Founding Growth Lead and have real influence on how intake scales

  • Ownership of a critical function at an early-stage, fast-growing company

  • The opportunity to materially impact how quickly families access care

  • A role where operational excellence directly translates to patient outcomes

Job details
Workplace
Remote
Location
United States (Remote)
Alpaca Health logo
Alpaca Health
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Alpaca Health helps families access high-quality ABA therapy quickly by partnering with trusted, locally owned BCBA practices, delivering personalized care in homes, schools, and community settings without long waitlists or corporate red tape. We handle intake, insurance, and support so families can focus on progress, while empowering local clinicians to stay independent and provide the kind of warm, relationship-driven care every child deserves.

Employees
17
Industry
Hospitals and Health Care
Headquarters
New York, New York
Founded
2024
Company location
New York, New York
Specialties
Applied Behavioral Analysis

Key team members

Francisco Javier Garcia Rosas

Francisco Javier Garcia Rosas

Michael Gao

Michael Gao

Sam Seelig

Sam Seelig

Madhav Asok

Madhav Asok

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