The Role :
You are the first verification point in the revenue cycle, responsible for ensuring accurate patient eligibility before claims processing.
As part of the Night Shift, you handle exception cases by directly contacting payers to verify coverage, resolve discrepancies, and ensure every chart is accurate and complete.
What You Will Own – Your Responsibilities :
- Phone-based payer follow-up — confirming coverage, network status, and prior authorization requirements for unresolved charts
- Escalation resolution — working through held charts that could not be resolved through the portal
- Status updates — documenting every call outcome and updating chart status in the system before shift end
- Trend reporting — flagging repeated payer issues or eligibility patterns to DS for process improvement
Non-Negotiable Metric :
First-Contact Eligibility Resolution Rate ≥ 85%
Percentage of eligibility cases fully resolved without escalation or secondary review
THE FIGHT: False Confidence :
We fight the assumption of coverage. The chart that “looked fine” or the portal that said active when the policy had lapsed. On the E&B team, nothing is assumed. Everything is confirmed.
WHAT WINNING LOOKS LIKE :
- Target: ≥ 85% resolution without escalation.
- Accuracy: 98% or above across all charts.
- Standard: Zero held charts older than 48 hours.
WHO THRIVES HERE :
- You verify, you do not assume. Last month’s status doesn’t matter. You check today.
- You document religiously. Your notes are the roadmap for the next person.
- You hold the standard. High volume never justifies reduced accuracy.
THE WWS PERKS :
- Full Training: We build you into an RCM expert from day one.
- Clear Structure: No guessing what your day looks like.
- Career Growth: You’ll learn how the entire healthcare financial engine works.
Qualifications:
- Experience: Minimum of 1 year in Revenue Cycle Management (RCM), medical billing, or insurance verification.(Prefered Night Shift)
- Communication: High-level verbal skills to navigate complex phone calls with insurance payers.
- Persistence: A “don’t stop until it’s solved” attitude. You don’t just report a problem; you find the answer.
- Documentation: Ability to write clear, professional notes so the next team member knows exactly what you confirmed.
Contact us on recruiter@wonderws.com / vk.rmt@wonderws.com/ 9047477375
To Apply: https://careers.wonderws.com
