The Role :
- Care cannot begin without authorization — your job is to get it approved the first time.
- In the Day Shift, you build the foundation for every approval by verifying eligibility, validating HCPCS codes, and assembling complete, submission-ready documentation. Every accurate submission prevents delays, denials, and rework.
- Your focus is simple: send it right the first time so it gets approved the first time.
What You Will Own – Your Responsibilities :
- Eligibility & coverage verification — confirming patient criteria and prior authorization requirements for each HCPCS code
- Submission package assembly — compiling medical necessity documentation, physician orders, and all required supporting records
- Code validation — ensuring HCPCS codes align with payer-specific guidelines
- Checklist compliance — ensuring every submission meets standardized completeness criteria
- Handoff to Night Shift — preparing structured, accurate, and audit-ready authorization packages
Non-Negotiable Metric :
- PRIOR AUTHORIZATION FIRST-PASS APPROVAL RATE · TARGET: ≥ 90%
- Your work directly impacts this metric — the more accurate the submission, the higher the first-pass approval rate.
The Fight: What You will Fight:
- The incomplete submission.
- Every denial caused by missing documentation, incorrect coding, or overlooked requirements starts here — before submission.
- Missing or incorrect documentation
- Process gaps that lead to rework and delays
At WWS — incomplete is not acceptable.
WHO THRIVES HERE :
- You are thorough before you submit — You check every detail before sending it forward
- You think in systems — You understand how each document impacts approval outcomes
- You own accuracy — You do not pass incomplete work to the next stage
THE WWS PERKS :
- Full training in prior authorization processes, HCPCS coding, and documentation standards
- A clearly defined Day Shift role with measurable quality metrics
- Strong coordination with Night Shift for end-to-end process ownership
- Exposure to payer requirements and real-world authorization workflows
- A performance-driven culture focused on accuracy and outcomes
Qualifications:
- Experience: 6 Months of experience in any field
- Education: Bachelor’s degree in any discipline
- Communication: Good verbal & written skills
- Analytical Skills: Basic ability to validate and review data
- Technical Skills: Basic MS Excel
- Attention to Detail: High accuracy in documentation and checklist-driven processes
Contact us on opportunities@wonderws.co / 9047477375
To Apply: https://careers.wonderws.com
