Job Summary: Medical billing analyst responsible for conducting audits, advising on authorizations, and providing technical support to the nursing department. Key Highlights: 1. Medical bill and billing analysis, including claim denials and consensus. 2. Technical advisory support to the authorization department. 3. Technical support for administrative matters in the nursing area. **Working Hours:** Monday to Friday, from 08:00 to 17:00. **Main Responsibilities:** \- Analyze medical bills and corresponding charges \- procedures performed, hospitalization period, materials used, etc., applying appropriate claim denials when necessary and reaching consensus upon request. * Provide advisory support to the authorization department by clarifying questions regarding various procedures, verifying requests for medications and materials, and analyzing the ANS procedure list and DUT. * Conduct qualified interviews with beneficiaries in specific cases to identify possible omissions of pre-existing conditions; * Assist with other administrative matters requiring technical input from the nursing area. **Requirements:** Bachelor's degree in Nursing Experience in nursing and auditing Desirable: Experience in health insurance plans Minimum Education Level: Postgraduate Specialization/MBA Preferred Education: Nursing, Higher Education * Payroll-deductible loan * TotalPass (after probationary period) * Life insurance * Dental care (after probationary period) * Birthday leave * Cafeteria * Shuttle service (departing from Praça Rui Barbosa in Curitiba, São José dos Pinhais, Colombo, and Quatro Barras) * Meal allowance: BRL 738.00 * Parking agreement with employee discount
João Silva
Indeed · HR
João Silva
Indeed · HR
