Billing Assistant

Description

Job Summary: Professional responsible for maintaining billing records (health insurance plans and SUS) up to date, enabling cash flow forecasting. Key Highlights: 1. Desirable experience in the hospital sector 2. Perform account reconciliation and closing 3. File appeals against claim denials with SUS and Supplementary Health Professional responsible for maintaining billing records (health insurance plans and SUS) up to date, enabling cash flow forecasting for the Institution. **Education/Experience:** * Completed high school or a course in administration, accounting, financial management, or related fields; * Desirable experience in the hospital sector. **Responsibilities:** * + Maintain confidentiality of SAME (Medical Records Service) documents and disclose them only in cases pre\-defined by the Institution's internal procedures; + Contribute to maintaining updated Standard Operating Procedures \- "SOPs". + Contribute, when necessary, to verifying physician fee payments and processing physician disbursements via the MV SOUL system. + Perform reconciliation of health insurance plan payments versus billed items in the MVSOUL system. + Verify billed items against information contained in medical records, close accounts, transmit XML files to health insurance operators, and prepare physical billing packages for dispatch. + Monitor SUS and Supplementary Health auditors, conducting investigations into identified discrepancies; + File appeals against claim denials with SUS and Supplementary Health; + Verify SUS medical reports; send SUS medical reports to SMSA (Municipal Health Secretariat); + Perform verification and closing of medical records (SUS); + Manage SUS patient procedures (Rehabilitation, Long-term Care, and Clinics); + Perform general billing for SUS / health insurance plan accounts; + Verify health insurance plan claim forms; + Forward documents to the SAME (Medical Records Service) archive; + Participate in Committees and/or Nuclei; + Provide efficient and effective administrative and/or clinical support to the originating unit and branches whenever reallocation is identified as necessary by the Rede Paulo de Tarso network. + Perform other related, inherent tasks, and tasks of common complexity associated with this position and organizational environment.