Customer Relationship Assistant

Description

Description: REQUIRED * High school diploma; * Customer service experience with authorization of medical exams and procedures; * Previous work in the health plan operator sector, accredited network (hospitals, clinics, laboratories); * Knowledge of ANS (Agência Nacional de Saúde Suplementar) regulations. DESIRED * Completed technical education and/or ongoing higher education; * Experience with TOTVS systems, Sys-on or similar; * Provide customer, partner, and provider support through existing communication channels, excluding in-person service, ensuring compliance with existing regulations in a way that guarantees meeting deadlines established by ANS and customer and partner satisfaction; * Support requests from partners related to service and/or authorizations at RAUF providers, requesting analyst support when difficulties arise; * Record all data and movements related to requests, attaching mandatory documentation in the Management System; * Carry out all processes required for serving beneficiaries under interstate exchange within the RAUF network; * Perform authorizations within the RAUF network for beneficiaries of Unimed Federação according to contractual coverage, medical audit opinion, and current regulations and legislation, requesting analyst support when difficulties arise; * When necessary, register hospitalized clients in Sys-on; * Send lists of hospitalized clients to partners whenever necessary; * Assist in maintaining departmental performance indicators and action plans; * Assist in mapping area processes and updating related documents; * Record Service Level metrics (non-conformities and complaints); * Generate and provide service protocols to beneficiaries; 251029020253673426