Denial Analyst

Description

Job Summary: We are seeking a committed, analytical, and solution-oriented professional to work as a Denial Analyst, identifying and analyzing denials issued by health insurance providers. Key Highlights: 1. Identify and analyze denials from health insurance providers 2. Prepare denial appeals with supporting documentation 3. Record and track payments in the internal system **POSITION:** Denial Analyst **WORK SCHEDULE:** 44 hours per week **SALARY:** BRL 2,700.00 (R$200.00 raise after 3 months) **BENEFITS:** Meal allowance BRL 30.00/day + Transportation allowance + Health insurance with co-payment (after 6 months) + Birthday day off (after 1 year) + University partnership discounts **JOB DESCRIPTION:** We seek a **committed**, **analytical**, and **solution-oriented** professional to join our Denial Appeal team. **TECHNICAL REQUIREMENTS:** * Minimum education: High school diploma and/or currently enrolled in undergraduate studies; * Experience and knowledge of contractual rules and denial appeals; * Proficiency in Simpro and Brasíndice journals, as well as AMB, CIEFAS, CBHPM, SBH, TISS, and TUSS standards; * Familiarity with ANS's ROL (List of Procedures); * Advanced proficiency in Microsoft Office suite; * Advanced knowledge of XML files; * Experience with Smart / Tasy systems; Experience with health insurance providers and the Zero Glosa platform is a **plus**. **BEHAVIORAL REQUIREMENTS:** * Clear, concise, and assertive written and oral communication; * Teamwork; * Strong interpersonal skills; * Commitment, initiative, and dynamism; * Attention to detail; * Agility and flexibility, working efficiently; * Organizational and planning skills; * Ability to remain calm and productive under high-pressure situations; * Proactivity and persistence. **RESPONSIBILITIES:** * Identify denials issued by health insurance providers using payment statements and account analyses; * Analyze denials based on contractual rules and standards including Simpro, Brasíndice, SBH, AMB, CBHPM, CIEFAS, TISS, TUSS, DUTs, and authorizations; * Prepare denial appeals with supporting documentation and submit them via spreadsheet, website, XML files, postal mail, or other formats requested by the health insurance provider; * Record protocols in the internal system (Smart/Zero Glosa) and monitor their payments; * Log errors causing denials to guide relevant departments and correct procedures/processes, and notify supervisors for oversight; Plus other duties pertinent to this role. Employment Type: Full-time CLT Compensation: BRL 2,112.59 – BRL 14,452.62 per month Benefits: * Medical assistance * Commercial partnerships and discounts * Meal allowance * Transportation allowance Screening Question(s): * Are you proficient in Simpro and Brasíndice journals? * Do you have advanced knowledge of XML files and Microsoft Office? Education: * Completed high school (Mandatory) Experience: * Denial appeals and knowledge of contractual rules (Mandatory) Work Location: On-site