MEDICAL AUDITOR

Description

Job Summary: This role involves internal and external auditing activities, analyzing medical and hospital accounts, and providing support for health campaigns. Key Highlights: 1. Internal and external auditing activities 2. Analysis of medical and hospital accounts 3. Support for health campaigns Selection Process: 51907 Salary: R$14\.875,78 State: RIO DE JANEIRO Assignment: COASS \- Assistential Coordination Applications until: 27/10/2025 1 position(s) #### **Benefits Offered** * Meal/Ticket Allowance (R$ 1\.275,00\) * Comprehensive Health and Dental Plan for family members * Private Pension Plan with equal employer-employee contribution * Group Life Insurance * Birth Allowance \- R$ 446,18 * Daycare Allowance \- R$ 669,30 (for children up to 7 years old) * School Allowance \- R$ 200,00 (for children aged 7 to 12 years) * Maternity Leave: 180 days * Paternity Leave: 20 days * Breastfeeding Leave (2 daily hours for breastfeeding during 6 months after returning from Maternity Leave) * Christmas Hamper Allowance: R$1\.445,40 * Culture Voucher \- R$ 50,00 (for employees earning up to 5 minimum wages) * Gym Allowance \- Reimbursement of R$100,00 upon submission of monthly payment receipt, after the probationary 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 Council) license Knowledge of CBHPM, ANS (ROL), and TUSS fee schedules Knowledge of material and drug pricing tables (Brasíndice and Simpro) Knowledge of hospital account and SADT/OPME guide auditing Experience in internal and external auditing routines Desirable: Postgraduate degree in Auditing. #### **Job Responsibilities **Read Carefully Perform internal and external auditing activities, including auditing of medical and hospital accounts (fees, daily rates, and charges) Analyze OPME requests Monitor discharge procedures when requested Conduct external visits (hospital/home) and visits to service providers Perform internal and external expert assessments Conduct analysis and appeal of claim denials Provide support for health campaigns promoted by GEAP Perform other duties relevant to the position. #### **Attention, Candidates** • GEAP values diversity, respect, and inclusion throughout its selection processes. As a Foundation committed to equity, we promote opportunities for all, 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 obligate GEAP to hire. As a private entity, GEAP reserves the right to modify or cancel selection processes at any time, with hiring conducted solely at GEAP’s discretion and based on available positions and business needs. * Incomplete curriculum registrations will be disregarded \- For each new entry, 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