Billing Assistant

Description

Job Summary: Professional to handle medical-hospital billing processes, administrative and financial routines, and compliance with audits. Key Highlights: 1. Handling billing for medical and hospital services 2. Knowledge of TUSS, CBHPM, and SIGTAP coding tables 3. Familiarity with ANS regulations and health insurance plan rules * **Job Requirements:** Education: High school diploma Additional courses in administration, billing, and Excel. * **Responsibilities:** Billing Processes: Issuing invoices and bills for medical and hospital services; verifying authorization and eligibility of orders and claim forms for billing (health insurance plans, SUS, private patients); recording and managing accounts receivable related to billing; organizing and maintaining documents (medical records, claim forms, reports, contracts) for audit and billing purposes. Administrative and Financial Routines: Organizing physical and electronic document folders; maintaining and updating registries (clients/patients, health insurance plans, suppliers); assisting in preparing managerial reports on billing and accounts receivable; handling and archiving various documents. Compliance and Audits: Calculating taxes on billing revenue; gathering data and documents to support audits and inspections; assisting in reconciling accounting entries and bank deposits. * **Required Knowledge:** Fee and Procedure Coding Tables: Proficiency in TUSS (Unified Health Supplement Terminology), CBHPM (Brazilian Hierarchical Classification of Medical Procedures), and SIGTAP (SUS Procedure Table). Audit and Claim Denial Rules: Understanding why health insurers deny payments (claim denials) and how the appeal process works. Electronic Billing: Knowledge of the Supplementary Health Information Exchange (TISS), ensuring electronic claim forms comply with required formats. Healthcare Legislation: Familiarity with ANS (National Supplementary Health Agency) regulations and health insurance contract rules. Basic Medical Terminology: Understanding names of tests, materials, and medications to verify whether billed items match procedures documented in medical records.