Billing Assistant

Description

Job Summary: Opportunity to work on medical and hospital billing, with a focus on analyzing, validating, and processing data related to health insurance plans, SUS (Unified Health System), and private patients. Key Highlights: 1. Process medical and hospital billing. 2. Handle administrative claim denials and billing pending items. 3. Maintain contact with health insurance providers and internal departments to expedite processes. We currently have an opening in the Billing Department — join our team! **Responsibilities:** Process medical and hospital billing; issue invoices; analyze correct billing according to contracts with health insurance providers and the Unified Health System (SUS); review administrative claim denials; Receive clinical production records from all productive hospital departments; Monitor daily submission of clinical production records according to schedules set by health insurance providers, SUS, and institutional private rules; Maintain contact with Clinical Support Assistants and Central Authorization Assistants to expedite the delivery of medical records and their authorizations, ensuring compliance with agreed deadlines; Conduct health insurance plan information queries, verifying data against tables agreed upon with insurers; Notify the Registration Department for appropriate handling whenever non-conformities are identified in the proprietary system/module; Perform analytical validation of medical records vs. authorizations vs. proprietary system, per criteria established by health insurance providers, SUS, and institutional private rules; Bill hospital accounts in the proprietary system and in systems of health insurance providers and SUS, as stipulated in contracts signed between parties; Handle medical and hospital charge slips, verifying data according to rules established with health insurance providers; Provide feedback to originating departments when process failures are identified; Record process failures in dedicated spreadsheets for non-conformity tracking; Provide courteous, prompt, and efficient service to internal and external customers; Monitor billing processes for health insurance plans, SUS, and private patients together with active Medical Auditors; Contact physicians, clinical support staff, assistants, analysts, receptionists, and nurses across departments to resolve hospital account-related pending items; Generate financial data for physician reimbursement and other healthcare professionals; Maintain contact with health insurance providers and SUS regarding hospital account-related matters; Verify and resolve system-related issues in coordination with IT and Registration departments; Perform data entry into information systems relevant to this role; Review administrative claim denials applied by health insurance providers and SUS; Log all incoming and outgoing billing-related documents, completing observation fields in detail. **Requirements:** Completed high school education Computer literacy Minimum six months of experience in the field **What We Offer:** * Market-competitive salary; * Medical assistance; * Dental assistance; * On-site meals at the hospital; * Transportation allowance; * Gympass