Description
Job Summary:
Professional responsible for reviewing and validating medical invoices, analyzing documents, entering/correcting data, and managing claim denials, while supporting departmental reporting.
Key Highlights:
1. Experience in analyzing and monitoring claim denials
2. Knowledge of medical fee schedules and health plan rules
3. Experience with hospital systems such as MV, Tasy, SPData
### **Main Responsibilities**
* Review and validation of medical invoices (CBHPM, TUSS, AMB);
* Analysis of authorization forms, medical reports, authorizations, and supporting documents;
* Data entry/correction in hospital information systems;
* Identification and appeal of claim denials;
* Electronic submission of invoices and communication with health insurance providers;
* Support in generating departmental reports and performance indicators.
### **Requirements:**
* Completed high school education;
* Technical or undergraduate program in progress (Administration, Accounting, Hospital Management, or related fields);
* Experience with MV, Tasy, SPData, or similar systems;
* Knowledge of medical fee schedules and health plan rules;
* Intermediate/advanced Excel proficiency;
* Experience in analyzing and monitoring claim denials.
### **Benefits:**
* Workload: 44 hours/week
* Schedule: Monday to Thursday, 7:00 AM–5:00 PM; Friday, 7:00 AM–4:00 PM
* Meal and food vouchers
* BenSaúde Health Plan
* Dental Plan
* Childcare Assistance
* Life Insurance
**BeneValoriza Program:**
* Wellhub (Gympass – Gyms and Wellness)
* Vidalink
* Birthday Day Off
* Pluxee Cuida: Psychological, legal, financial, and nutritional support
* Discounts at partner establishments
* Monthly Birthday Celebrations
All our job openings are also open to candidates with disabilities.
Minimum Education Level: High School (Secondary Education)