Job Summary: Nursing professional for auditing medical records, supplies, and procedures to optimize costs and improve healthcare quality. Key Highlights: 1. Nursing care audit and critical analysis 2. Focus on continuous improvement and reduction of healthcare costs 3. Collaborative practice with providers and continuing education **Requirements:** * Completed undergraduate degree in Nursing; * Active and regular COREN registration; * Personal vehicle, insured, with driver's license category B; * Experience in nursing assistance routines in ICU, Surgical Center; knowledge of OPME (Orthopedic, Prosthetic, and Medical Equipment), auditing, SAE (Healthcare Assistance System), and health-related standards and legislation. **Responsibilities:** * Conduct retrospective manual and electronic audits of supplies, medications, OPME, and procedures in medical records of discharged patients made available by healthcare service providers, based on contractual agreements, audit manuals, and internal protocols; * Perform concurrent audits for inpatients in ICU, Surgical Center, or other situations as requested, recording necessary information; * Reach consensus with healthcare service providers regarding discrepancies identified in invoices, delivering continuing education; * Report non-conformities, changes in provider routines—including modifications to standardization of supplies and medications—directly to the Nursing Analyst or Audit Supervision; * Record process-related information for statistical analysis to support evaluations and decision-making; * Assess and report opportunities for process improvement aimed at optimizing activities and reducing healthcare costs; * Critically evaluate the quality of provided care and report technical discrepancies and identified distortions to the Nursing Analyst; * Record information related to beneficiaries of exchange programs in the designated Exchange Report form; * Forward provider inquiries to the Nursing Analyst; * Organize the billing workflow for auditing, supporting Medical Auditing; * Monitor and ensure compliance with scheduled audit deadlines and account closure timelines (SLA and accounting periods); * Review re-submission/complement protocols; * Prepare technical opinions on inpatients, supplies, equipment, medications, related legislation, and other matters; * Participate in developing new projects (as per technical expertise) when requested; * Support execution of other department/unit activities at the supervisor’s discretion; * Attend training sessions and courses to enhance auditing skills; * Provide technical guidance to team members. Unimed Curitiba and other group companies oppose any form of discriminatory conduct. Therefore, in all Talent Attraction and Selection processes, any discriminatory practice is prohibited for purposes of entering into or maintaining an employment relationship, based on gender, origin, race, color, marital status, family situation, disability, professional rehabilitation, age, religion, culture, or other factors. **Minimum Education Level:** Undergraduate Degree
João Silva
Indeed · HR
João Silva
Indeed · HR
