Authorization Assistant

Description

Authorization Assistant (Health Insurance Providers) Location: Remote Employment Type: CLT Schedule: Monday to Friday, from 09:00 to 18:00 Job Description We are seeking a professional with strong analytical skills and solid experience in the supplementary health authorization lifecycle. You will serve as the focal point between clinical departments and health insurance providers, responsible for ensuring the financial and operational viability of procedures, mitigating claim denial risks, and guaranteeing strict compliance with contractual obligations. Key Responsibilities: Authorization Lifecycle Management: Request, monitor, and audit authorization processes for medical procedures. Technical Analysis of Billing Forms: Validate clinical documentation and billing forms (SADT, SP/SADT, TISS) according to the ANS List and specific contracts. Strategic Interface: Engage in technical dialogue with health insurance providers to reverse denials and adjust eligibility criteria. Preventive Denial Control: Monitor deadlines and pending items to avoid financial losses due to authorization failures. Billing Support: Accurately populate internal systems and control spreadsheets to ensure revenue flow. Organization and Compliance: Maintain proper archiving and record-keeping of evidence for internal and external audits. Mandatory Requirements: Education: Completed or ongoing undergraduate degree in Hospital Management, Business Administration, or related fields; Proven Experience: Prior solid experience in health plan authorization (hospitals or clinics). Technical Proficiency: In-depth knowledge of TISS/TUSS standards and navigation of health insurer portals. Billing Acumen: Understanding of fee schedules (Simpro, Brasíndice, CBHPM) and billing workflows to support the finance department. Computer Skills: Intermediate Microsoft Office suite (with emphasis on Excel for control reporting). Behavioral Profile Analytical Rigor: Attention to technical details to prevent data entry errors and inconsistencies. Assertive Communication: Negotiation ability and clarity when interacting with payers. Time Management: Focus on delivering results under contractual deadline pressure. Proactivity: Anticipating issues arising from incorrectly completed billing forms before submission to insurers. Compensation: R$2\.500,00 \- R$2\.700,00 per month Work Location: Remote