Technical Audit Assistant

Description

Job Summary: Professional responsible for monitoring, recording, and contacting providers for clarifications, as well as managing data and documents in the healthcare area. Key Highlights: 1. Monitoring and management of health declarations and reimbursement requests 2. Contacting providers and researching ANVISA regulations and TUSS codes 3. Organizing data, preparing spreadsheets, and completing management ritual closures Monitor and forward health declarations to the service unit. Monitor requests regarding validation of material and medication parameters. Monitor and record reimbursement requests. Monitor medical-hospital bills submitted via electronic billing. Contact providers for clarification regarding materials and medications requested for authorization. Perform other related tasks as needed or at the manager's discretion. Research ANVISA records and TUSS codes whenever necessary. Conduct system homologation tests. Record performance indicator data for the Unit. Register completed audits in PEP using the audit document. Respond to inquiries from "Fale Conosco" (Contact Us) and FUNDATENDE. Monitor and track MV emails and workflows. Monitor and evaluate reimbursement returns processed by the third-party service. Prepare and maintain updated spreadsheets. Perform monthly closure of management rituals and update the annual report. Monitor and forward concurrent audit reports (DRG). Monitor and submit the hospital census and patient list. Monitor and evaluate the ANVISA website and updates to TUSS versions in ANS tables. Request alerts at the service unit for beneficiaries with autism spectrum disorder (ASD) or other special needs. Knowledge of ANS regulations, ANVISA website, CBHPM, and tables used in the healthcare area. Agile, focused, organized, collaborative, dynamic, punctual, proactive, responsible, solution-oriented, discreet, and diligent. Employment Type: Full-time, Permanent CLT Compensation: R$2.666,15 per month Benefits: * Medical assistance * Commercial agreements and discounts * Life insurance * Meal allowance * Food allowance * Transportation allowance Education: * Completed high school (preferred) Experience: * Experience in healthcare and health plans (mandatory) Work Location: On-site