MEDICAL AUDITOR

Description

Job Summary: The professional will perform internal and external audit activities, OPME order analysis, and support for health campaigns. Key Highlights: 1. Internal and external audit activities 2. Order analysis and discharge follow-up 3. Support for health campaigns and external visits Selection Process: 52015 Salary: R$15\.634,44 State: RIO DE JANEIRO Assignment: COASS \- Clinical Coordination Applications until: 26/12/2025 1 vacancy(ies) #### **Benefits Offered** * Meal/Ticket Allowance (R$ 1\.425,00\) * Comprehensive Health and Dental Plan for family members * Private Pension Plan with equal employer-employee contribution * Group Life Insurance * Birth Allowance \- R$ 473,40 * 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 hours per day for breastfeeding during the first 6 months after returning from Maternity Leave) * Christmas Hamper Allowance: 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 probation period * Birthday Day Off * Security Professional Day Off (third Monday of October) #### **Prerequisites** Availability to work 30 hours per week (6 hours per day) Completed Higher Education in Medicine Active CRM (Medical Registration) Knowledge of CBHPM, ANS (ROL), and TUSS fee schedules Knowledge of materials and pharmaceuticals pricing tables (Brasíndice and Simpro) Knowledge of hospital billing and SADT/OPME form audits Experience in internal and external audit routines Desirable: Postgraduate degree in Auditing. #### **Job Responsibilities **Please Read Carefully Perform internal and external audit activities, including medical and hospital billing audits (fees, daily rates, and charges) Analyze OPME orders Follow up on patient discharge when requested Conduct external visits (hospital/home) and visits to service providers Perform internal and external expert assessments Analyze and appeal claim denials Provide support for GEAP's health promotion campaigns Perform other duties relevant to the position. #### **Attention Candidates** • GEAP values diversity, respect, and inclusion in its selection processes. As a Foundation committed to equity, we 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 compatibility with the requirements published for this position will be deemed ineligible for the selection process. * Participation in and approval of evaluation stages do not create any obligation to hire. As a private entity, GEAP reserves the right to modify or cancel its selection processes at any time, carrying out hires based on interest and available vacancies at the appropriate time. * Incomplete curriculum registrations will be disregarded \- For each addition, 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 BENEDITO HIPOLITO, Nº 216 \- CIDADE NOVA, RIO DE JANEIRO\-RJ