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Job Summary: Nursing professional for medical and hospital billing audits, conducting home visits and ensuring proper execution of procedures. Key Highlights: 1. Experience in medical and hospital billing audits 2. Conducting home visits and clinical assessments 3. Identifying risks and implementing preventive measures Description: Requirements: * Bachelor's degree in Nursing; * Postgraduate qualification in Health Auditing is desirable; * Experience in medical and hospital billing audits; * Intermediate proficiency in Microsoft Office suite; * Active registration with the professional regulatory council. A brief overview of your daily responsibilities: * Conduct home visits to assess clinical condition, home environment, and treatment progress; * Conduct on-site home visits to evaluate eligibility criteria for program continuation (complete NEAD and ABEMID forms); * Ensure correct execution of procedures and adherence to clinical care routines; * Contact requesting physicians when prescription-related questions arise; * Identify risks and implement preventive measures, including guidance on infections, falls, medication, and other adverse events; * Conduct technical visits, re-evaluations, or possible patient discharges, per internal protocols and health plan operator requirements; * Assess patients for potential referral to outpatient services (specialized clinics). Complete visit reports and communicate complications or urgent intervention needs to the internal team; * Support internal departmental tasks, including extensions, preliminary analyses, injunctions, as well as monitoring spreadsheets and performance indicators, among other related activities. 2511130202461866153
