Job Summary: Hospital bill and medical record analyst to ensure technical compliance, optimize resources, and guarantee the quality of healthcare processes. Key Highlights: 1. Technical audit of hospital bills 2. Negotiation and mediation of claim denials 3. Monitoring of quality indicators Conducts technical and administrative analysis of hospital bills and medical records, verifying consistency between billed items and services rendered. Ensures technical compliance, identifies claim denials, and optimizes resources, thereby guaranteeing the quality and sustainability of healthcare processes. * Technical audit of hospital bills (prior, concurrent, or retrospective). * Beneficiary visit: Updating clinical status and managing pending issues; * Beneficiary visit: Assessing appropriateness of accommodation and proposing discharge from hospitalization. * LP meetings: Participation in meetings with the health plan operator to discuss long-term hospitalized patients; * Adverse events: Identification and reporting of identified adverse events; * Collaborate closely with other professionals; * Analysis of extensions: Medical audit of hospital daily rates requested by providers to the health plan operator; * Identify opportunities to improve work productivity and efficiency; * Stay updated on regulations and guidelines related to fee schedules; * Early identification of potential errors in billing rules/entries requiring correction; * Organize time to deliver assigned tasks aiming for results. * Medical record review, verification of medications, supplies, and fees. * Preparation of technical opinions and non-conformance reports. * Negotiation and mediation of claim denials with providers and health plan operators. * Monitoring of quality and healthcare assistance indicators.