Nursing Auditor

Description

Job Summary: Nursing Auditor for the Audit team, responsible for reviewing medical bills, guiding billing staff, and analyzing claim denials, with a focus on quality and continuous improvement. Key Highlights: 1. Integrate the Audit team with challenges in the healthcare sector 2. Perform medical billing analysis and process improvement 3. Teamwork, initiative, and results-oriented mindset **POSITION:** Nursing Auditor **WORK SCHEDULE:** 44 hours per week **SALARY:** R$4.054,76 **BENEFITS:** Meal allowance R$28.00/day + Transportation allowance + Health insurance with co-payment (after 6 months) + Birthday leave (annual day off after 1 year) + University partnership agreements **JOB DESCRIPTION:** We are seeking professionals to join our Audit team as Nursing Auditors. **TECHNICAL REQUIREMENTS:** * Bachelor's degree in Nursing; * Postgraduate degree in Audit; * Active COREN registration; * Experience in auditing and clinical practice; * Proficiency in computer applications; * Availability to work 44 hours per week **RESPONSIBILITIES:** * Receive and verify medical bills against patient records and store documents according to health plan divisions; * Provide technical guidance to billing staff regarding necessary corrections following pre-audit of medical bills; * Identify inconsistencies in patient records and monitor corrective actions in processes; * Coordinate with auditors to schedule visits in accordance with health plan delivery schedules; * Analyze claim denials and appeal them with health plan auditors; * Engage internal teams to investigate inconsistencies in entries and records within patient files; * Verify processes, procedures, and use of hospital supplies and medications; * Carry out activities in compliance with the Organization's Quality System and Policies. **BEHAVIORAL REQUIREMENTS:** * Teamwork; * Commitment, initiative, and dynamism; * Effective communication; * Strong interpersonal skills; * Proactivity and persistence; * Agility and flexibility, working efficiently; * Results-oriented mindset; * Organizational and planning skills. **If you are a healthcare professional passionate about this field and seeking new challenges, join our team!** Employment Type: Full-time CLT Benefits: * Meal allowance * Transportation allowance Screening Question(s): * Do you hold a postgraduate degree in Nursing Audit? Education: * Completed postgraduate degree (Mandatory) Experience: * Nursing Auditor (Mandatory) License/Certification: * COREN registration (Mandatory) Work Location: On-site