Prior Authorization Specialist

Alpaca Health

7h • Onsite

About The Position

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.

Requirements

• 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

Responsibilities

• 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

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed