Prior Authorization Specialist

Alpaca Health

. Own the authorization process for complex cases, with expertise in TRICARE, including ECHO enrollment and prior authorization workflows .

Posted 11/2/2026full-timeRemote • PhilippinesMid-LevelSenior💰 $500 - $1,000 per monthWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing complex authorization processes, particularly with TRICARE and ECHO enrollment, while ensuring effective communication and problem resolution among families, clinical staff, and insurance operations.

Highest-signal resume keywords

TRICARE AuthorizationsPrior Authorization WorkflowsABA Intake ExperienceProcess ImprovementClear Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Authorization Process ManagementDocumentation Follow-UpEscalation ManagementTracking and ReportingWorkflow Optimization

Soft Skills

Problem-Solving AbilityStrong Follow-ThroughApproachableSupportiveSound Judgment

Industry Keywords

ECHO EnrollmentPayer RequirementsBilling OperationsInsurance OperationsFamily Communication

About the role

Key responsibilities & impact

Own the authorization process for complex cases, with expertise in TRICARE, including ECHO enrollment and prior authorization workflows
Manage escalations from prior authorizations vendor Silna
Support documentation follow-up, authorization rejection resolution, and navigation of payer requirements
Partner with billing and insurance operations to resolve issues
Ensure timely and clear communication among families, BCBAs, referring physicians, and internal teams
Set expectations with families regarding timelines, documentation requirements, and next steps
Handle high-stakes or escalated family situations
Identify bottlenecks and inefficiencies across the intake workflow with operations
Own process improvements from identification through implementation
Maintain accurate tracking and reporting across systems

Requirements

What you’ll need

5+ years of experience in ABA intake
Specific focus on prior authorizations highly preferred
Direct experience with TRICARE authorizations, including ECHO enrollment and prior authorization workflows
Highly organized with strong follow-through
Clear and confident communication with families, clinical staff, and referring physicians
Problem-solving ability
Ability to make sound judgment calls in real time amid ambiguity
Approachable and supportive while maintaining high standards

Benefits

Comp & perks

Opportunity to materially impact how quickly families access care
Operational excellence directly translates to patient outcomes
Participation in a critical function at an early-stage, fast-growing company
Join a team of high-performing professionals in the ABA space