Job Summary: Professional responsible for auditing hospital accounts, verifying supplies, medications, daily charges, and procedures, as well as analyzing claim denials and pursuing continuous process improvement. Key Highlights: 1. Detailed hospital account auditing 2. Analysis and reversal of claim denials 3. Continuous process improvement and team guidance Position: Nursing Auditor Workload: 220 hours Working Hours: 7:30 AM to 5:30 PM Requirements: Completed Bachelor's Degree in Nursing Active registration with COREN Postgraduate degree in Auditing is a plus Main Responsibilities: Perform detailed counting of supplies and medications on hospital accounts, verifying administration and actual documentation in the medical record. Verify billing for daily charges, fees, and procedures, making necessary corrections to hospital accounts to ensure billing accuracy. Analyze claim denial situations, monitor on-site or remote audits conducted by health insurance providers, and prepare technical justifications to reverse unjustified denials. Complete and analyze control items, actively seeking process improvements in collaboration with responsible departments. Guide nursing teams regarding irregularities identified in hospital accounts, aiming to improve documentation and ensure technical compliance. Desired Profile: Strong interpersonal skills; Teamwork; Organization. Minimum Education Level: Bachelor's Degree * Gympass * Meal allowance * On-site meals * Medical assistance * Dental assistance * Transportation allowance * University discounts
João Silva
Indeed · HR
João Silva
Indeed · HR
