Alpaca Health

Alpaca Health

Prior Authorization Manager

United States (Remote) · Full-time

Sponsorship not specifiedDetected 9 days ago
EHR/EMROrganizational Skills

About the role

  • 📌 ABOUT ALPACA HEALTH Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.
  • Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.
  • More importantly, we're serving thousands of patients, while growing 30% - 50% MoM.

Responsibilities

  • Develop processes and training materials for offshore team members to resolve day-to-day prior authorization issues
  • Own Prior Authorization outcomes and KPIs for your region / payors
  • Extreme detail orientation and ability to read complex clinical documents, payor feedback, and EHR data with regards to prior authorization workflows
  • Support the team in chasing down documentation, resolving auth rejections, and navigating payer requirements
  • We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure.

Requirements

  • [REQUIRED] 5+ years of experience in ABA intake with a specific focus on Prior Authorizations or Insurance Certification
  • [REQUIRED] Strong understanding of the ABA pre-certification process for Tricare East, Medicaid MCOs, BCBS State plans, Aetna, and/or Cigna
  • You are highly organized and relentless about follow-through, nothing falls through the cracks on your watch
  • 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

Benefits

  • 📌 ABOUT ALPACA HEALTH
  • Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.
  • The opportunity to materially impact the health outcomes of the most vulnerable populations
  • Opportunity for rapid career growth as we build out a net new function at Alpaca Health
  • Join one of the fastest growing healthcare startups in the world (between 30% - 50% monthly growth)
  • Join a team of rockstar performers who are taking a new tech first approach to building a scalable digital health platform
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This listing is sourced directly from Alpaca Health's careers page and normalized into a canonical job model.