Selection process: 52016 Salary: R$8.721,99 State: Amapá Assignment: COASS – Assistance Coordination Registrations until: 12/22/2025 1 vacancy(ies) #### **Benefits Offered** * Meal/Ticket Allowance (R$ 1,900.00) * Comprehensive Health and Dental Plan for the employee’s family group * Private Pension Plan with equal employer-employee contributions * Group Life Insurance * Birth Allowance – R$ 446.18 * Daycare Allowance – R$ 710.13 (for children up to 7 years old) * School Allowance – R$ 212.20 (for children aged 7 to 12 years) * Maternity Leave: 180 days * Paternity Leave: 20 days * Breastfeeding Leave (2 daily hours for breastfeeding during the first 6 months following return from Maternity Leave) * Christmas Hamper Allowance in the amount of R$1,533.57 * Culture Voucher – R$ 50.00 (for employees earning up to 5 minimum wages) * Gym Allowance – Reimbursement of R$100.00 upon submission of proof of monthly membership payment, after the probationary period * Birthday Day Off * Securities Professionals’ Day Off (third Monday of October) #### **Prerequisites** Bachelor’s degree in Nursing. Active registration with the respective professional regulatory council. Prior experience in the duties associated with this position. #### **Job Description – Read Carefully** * Audit medical-hospital bills, verifying medications and materials listed on healthcare service invoices * Conduct technical analysis assessing the quantitative appropriateness and relevance of materials and medications listed on hospital invoices * Identify distortions in the use of materials, medications, or services provided to beneficiaries, as well as improper charges * Validate the use of high-cost materials * Verify TISS and TUSS invoices related to outpatient procedures, exams, and serial procedures; apply claim denials where necessary * Conduct audits of hospitalization, Home Care, and serial procedure (chemotherapy) invoices at accredited facilities lacking on-site auditing capacity * Apply claim denials to non-compliant hospital invoices and notify the accredited provider accordingly * Respond to claim denial appeals, using supporting documentation and operational technical information as criteria for approving or rejecting such appeals * Issue purchase authorizations for materials to suppliers and accredited hospitals * Provide technical support and guidance regarding billing for fees, equipment, and other items * Attend meetings with accredited providers to clarify doubts and disseminate information about plan coverage and procedure billing * Visit beneficiaries hospitalized at healthcare institutions, observing clinical status, progress notes, medication usage and procedures performed, and assessing beneficiaries’ satisfaction with received care * Assess the quality of hospital, clinical, laboratory, and auxiliary diagnostic and treatment services, as well as nursing care delivered * Review beneficiaries’ medical records, evaluating the quality of documentation, treatment, and case progression, and recording personal observations regarding each case and its management * Interact with the accredited provider’s clinical staff to facilitate beneficiary discharge and transition into Home Care services * Prepare reimbursement processes to SUS (Unified Health System), oral chemotherapy programs, auctions, and other services, to enable payment release * Perform other related and ancillary duties within the scope of this role. #### **Attention, Candidate** • GEAP values diversity, respect, and inclusion throughout its selection processes. As a foundation committed to equity, we actively promote opportunities for all individuals, without distinction based on gender, race, sexual orientation, age, or religion. • Applying for this position does not guarantee participation in evaluation stages. Candidates lacking alignment, expertise, or curriculum adherence to the requirements publicly specified for this position will be deemed ineligible for the selection process. * Participation in and approval through evaluation stages does not create an obligation to hire. As a private company, GEAP reserves the right to modify or cancel its selection processes at any time, and hires will be made solely based on business needs and available positions at the appropriate time. * Incomplete curriculum registrations will be disregarded — For each new entry, users must always click the (+) icon. Add Experience The curriculum registration system does not accept file attachments; all required fields must be manually entered. Work location: RUA BINGA UCHOA, 28 – CENTRO, MACAPÁ-AP