**None:** Summary of the position A Health Information Analyst is a highly important professional for healthcare institutions, primarily responsible for analyzing clinical statements and applying standard coding systems. Reviews patient records to determine whether a condition was present on admission or not, identifies issues related to inconsistent, missing, conflicting, or unclear documentation to be resolved by the attending physician. Conducts diagnostic analysis of non-conformities in clinical processes through medical record audits, aiming to enhance quality of care while reducing waste and improving operational outcomes. Mandatory Prerequisites Bachelor's degree in Nursing (mandatory); Active Regional Nursing Council (COREN) registration; Completed or ongoing specialization in hospital auditing; Experience in nursing care; Intermediate proficiency in Microsoft Office suite. **Desirable Prerequisites:** Experience in hospital auditing; Desirable specializations (hospital management, obstetrics, neonatology, hemodynamics, emergency and critical care, oncology, nephrology); Familiarity with the DRG Brazil platform. **Specific Knowledge:** Knowledge of ICD, TUSS tables, and CBHPM; Solid knowledge of medical terminology, anatomy, pathophysiology, and pharmacology; Technical expertise and understanding across various areas covered by audits (clinical, surgical, pediatric, obstetric, oncologic, hemodynamic admissions, and intensive care units); Knowledge of hospital cost structures. Required Technical Skills / Required Technical Procedures Critical thinking; Systemic perspective; Time management. Problem solving; Creativity and innovation; Results orientation; Emotional intelligence; Accountability; Analytical skills; Communication skills. Duties and Responsibilities Perform rigorous medical record audits to verify technical compatibility, quality, and efficiency of care; Code admissions and discharges on the DRG Brazil platform; Code all health data completely and accurately, in accordance with regulatory standards and applicable laws and regulations; Code only those codes and data that are clearly and consistently supported by documentation in the medical record, according to the appropriate coding system, requesting clarifications when necessary and additional documentation prior to code assignment where conflicts exist or information is incomplete or ambiguous; Ensure precise DRG assignment—a critical decision directly impacting reimbursement rates and performance metric generation—relying on physician documentation as the ultimate basis for final selection; Review medical records to locate documentation clarifying the final diagnosis recorded on the admission sheet and/or discharge summary, potentially enabling assignment of a more specific code number; Adopt accurate, complete, and consistent practices for generating high-quality health data; Advance coding knowledge through continuous education; Understand disease processes, anatomy, physiology, pharmacology, clinical documentation, and the full framework governing diagnostic and procedural coding to effectively draw conclusions from physicians’ documented information; Continuously safeguard the confidentiality of health records and refrain from accessing protected health information not required for coding activities (LGPD Law); Demonstrate integrity, reflecting commitment to ethical and legal coding practices and reinforcing professional trust; Interact with multidisciplinary teams; Participate in the Patient Safety Committee and Medical Record Commission; Analyze overall DRG performance reports and participate in meetings regarding economic and clinical opportunities with service providers; Contribute to hospital accreditation projects; Maintain updated protocols, guidance manuals, procedures, and work routines in compliance with current legislation to ensure adherence to standards; •Report infectious and non-infectious adverse events on the DRG platform and the provider’s system; Attend monthly management meetings; Collaborate with the team in maintaining workplace equipment and supplies. **None:** None
João Silva
Indeed · HR
João Silva
Indeed · HR
