Stefanini Brasil

Dental Auditor

Stefanini Brasil

full-time

Posted on:

Location Type: Hybrid

Location: Barueri • Brazil

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About the role

  • Analyze procedures requiring prior authorization and reassessment of denials;
  • Conduct technical reviews of dental treatments performed by the provider network, determining reimbursement or payment denials;
  • Review technical appeals of claim denials;
  • Participate in fraud prevention and detection processes, conducting audits/investigations of providers and beneficiaries;
  • Respond to requests and complaints from beneficiaries and/or providers;
  • Handle matters related to Legal, ANS (Brazilian National Supplementary Health Agency) and other channels;
  • Support requests and provide dental technical guidance to other internal teams;
  • Perform reimbursement analyses;
  • Assist in the development of system improvements and system validations (homologations);
  • Perform ad-hoc analyses as required: claim analysis, provider analysis, policyholder/plan sponsor analysis, area KPI analysis, etc., and prepare reports.

Requirements

  • Degree in Dentistry;
  • Experience in dental auditing at health plan operators or insurance companies and in clinical dental practice;
  • Training in Auditing or other related administrative areas;
  • Proficient in Microsoft Office (Office suite);
  • Specialist qualification in Dentistry, postgraduate degree, or MBA in related fields.
Benefits
  • Meal allowance or meal voucher;
  • Discounts on courses, universities and language schools;
  • Stefanini Academy — platform with free, up-to-date online courses with certification;
  • Mentoring;
  • Benefits club for consultations and examinations;
  • Medical assistance/health insurance;
  • Dental assistance/dental insurance;
  • Benefits club with discounts at leading establishments;
  • Travel club;
  • Pet care partnership/benefits.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
dental auditingreimbursement analysistechnical reviewsfraud preventionauditssystem improvementssystem validationsad-hoc analysesclaim analysisprovider analysis
Soft Skills
communicationproblem-solvinganalytical thinkingattention to detailinterpersonal skills
Certifications
degree in Dentistryspecialist qualification in Dentistrypostgraduate degreeMBA in related fields