Unimed Nacional

Billing Specialist

• Monitor, analyze and perform the company's billing for lower-complexity activities related to agreements and services provided to Legal Entities (PJ), Individuals (PF), interchange and SMEs, by analyzing received information to ensure proper charge collection, working under occasional guidance.
• Support the execution of analysis procedures, checks, issuance and submission of mandatory documentation made available via virtual disk, Unimed do Brasil Portal, physical media, bank slips (boletos), invoices and usage statements for individuals.
• Assist with billing reconciliation by analyzing and verifying data to ensure accuracy of amounts.
• Contribute to the analysis of denials (glosas) related to interchange, issue billing and send to UNIMED, manage AJIOS - Interchange Adjustment in the UNIMEDs System, and, if necessary, file disputes and issue debit or credit notes for partial payments.
• Issue Notas Fiscais (tax invoices) to Unimeds, perform billing, carry out collections, and control invoice deliveries.
• Prepare monthly invoices and bank slips (boletos), make bank remittances using the company's computerized system, and submit them to the bank, working under guidance.

Junior Billing Analyst

Auditor

• Realizar auditoria de contas médicas e procedimentos, analisando tudo o que foi usado no procedimento e respectivos valores, confrontando pedido médico, notas fiscais, etc., auditando e processando as contas no dia a dia do paciente, e também auditando os concorrentes no que foi gasto e usado, atuando de forma ética e profissional na área médico-administrativa em conformidade as normas técnicas de Auditoria Médica, proporcionando a organização a melhoria constante da qualidade dos seus serviços e indicadores econômicos através do manejo sustentável da sinistralidade e controle sistemático dos custos hospitalares.
• Realizar auditoria dos procedimentos, verificando guias, elegibilidade da guia, se os materiais foram cotados, verificando se a guia é pertinente, se está atualizada, confrontando as informações da guia com o procedimento e materiais utilizados.
• Efetuar a auditoria nos Serviços Ambulatoriais de Apoio Diagnóstico e Terapêutico, analisando se são compatíveis todos os procedimentos e custos, checar informações em geral, efetuando a glosa do procedimento quando não procedente.
• Analisar as guias detalhadamente, verificar item a item o que foi utilizado, comparar com a solicitação e procedimento, aprovando a autorização e/ou definindo a glosa.
• Realizar a revisão e avaliação contínua de conformidade de registros e procedimentos realizados, comparativamente as normas e procedimentos, legislação, tomando providências de glosa quando compatíveis.
• Desenvolver estudos, compilar informações, apresentar indicadores, com o objetivo de auxiliar na gestão das liberações de cirurgia, relatórios gerenciais e análises financeiras.
• Checar os pedidos, confrontando com os prazos da ANS., controlando a liberação de prazos.
• Executar e auditar faturamento de contas hospitalares, utilizando ferramentas básicas: contratos, tabelas acordadas e cálculos matemáticos para cobrança correta.
• Realizar acompanhamento de entrada do que está sendo cotado ou não e inspecionar a saída, analisando e orientando as áreas envolvidas.
• Checar informações em geral, efetuando a glosa do procedimento quando não procedente.
• Relacionar todas as informações referentes a cada cirurgia solicitada, gerando relatórios e controlando o fluxo de liberação.

Pessoa Médica Auditora – Auditoria Prévia

Administrative Assistant

• Apoio aos processos administrativos em todas as áreas da organização, abrangendo diversas naturezas de trabalho.
• Registro de entrada e saída de documentos.
• Tratamento completo de documentos (desde a elaboração até o recebimento e autorizações).
• Garantia do cumprimento de todos os procedimentos necessários.
• Realização de contatos e atendimentos telefônicos.
• Atendimento a fornecedores, público externo e colaboradores de outros departamentos.
• Fornecimento e recebimento de informações pertinentes à área.
• Preparação de relatórios detalhados.
• Desenvolvimento de planilhas de acordo com as diretrizes específicas de cada setor.
• Monitoramento contínuo das rotinas e fluxos de trabalho.

Assistente Administrativo

General Counsel

• Será responsável por executar atividades relacionadas à assistência jurídica e a defesa judicial e extrajudicial dos interesses da Empresa, em processos, nas esferas administrativas e judiciais, acompanhamento e controle de provisões e identificação de causa raiz, bem como, subsidiar a tomada de decisões, mediar questões, orientar conduta da Empresa, elaborar contratos e demais documentos e relatórios, analisar legislação vigente e dar assistência em negociações.
• Prestar assistência jurídica nas esferas administrativa e judicial em processos.
• Elaborar de peças de defesa tanto na esfera administrativa quanto na judicial.
• Analisar casos concretos e emitir pareceres que subsidiem a tomada de decisões.
• Elaborar minuta de documentos e contratos diversos, bem como, mediar e assessorar negociações.
• Garantir assertividade na análise e registro de provisões e causa raiz.
• Analisar e acompanhar a legislação sob supervisão.
• Revisar de peças elaboradas por terceiros, análise de conveniência de provas, estratégias e impugnação e garantias, oportunidade/necessidade de interposição de recursos e deliberação para realização de acordos.
• Cumprir o regulamento interno, os requisitos dos sistemas de gestão da qualidade, observação e cumprimento das regulamentações da ANS, bem como das normas e procedimentos de saúde, higiene e segurança do trabalho inerentes ao setor, a utilização de EPIs/EPCs (Equipamento de proteção individual/ Equipamento de proteção coletivo) quando a atividade assim o exigir.
• Desenvolver outras atividades inerentes ao cargo ou a critério de seu superior imediato, desde que habilitado e que estejam de acordo com o seu conhecimento e experiência.

Advogado Júnior

Analyst

• Validate the application of the contractual index (IPCA) according to the conditions established in the contract, performing checks and making annotations when necessary.
• Conduct periodic visits to providers, focusing on operational contract monitoring and institutional relationship management.
• Support providers in communication with the head office, acting in situations with low resolvability to restore operational flow and the relationship.
• Collect and analyze provider performance indicators, with a focus on billing, care profile and service delivery, preparing comparisons and management input.
• Monitor network qualification according to criteria defined by the head office, ensuring adherence to mandatory regulations and internal guidelines.
• Execute the documentation process for new credentialing, ensuring registration and regulatory compliance.
• Perform systematic evaluation of new credentialing according to pre-established criteria.
• Monitor the registration progress of new providers, ensuring information is up to date and consistent.
• Verify the alignment of the new provider's profile with the conditions defined by the Interchange area, reporting deviations when identified.
• Assist providers through multiple communication channels, logging and following up on requests according to defined workflows.

Provider Network Analyst

Compliance

• Act as the technical reference for the Compliance Program to ensure Unimed CNU operates in compliance with applicable laws, sector regulations and internal policies.
• Maintain a holistic view of the business, including process management, risk management, internal controls and strategic planning.
• Work in an integrated manner with other lines of defense, supporting business areas and periodic audits.
• Prepare executive reports for Committees and the Executive Board.

Senior Compliance Analyst

• Serve as the technical reference for the Integrity Program to ensure Unimed CNU operates in compliance with laws, sector regulations, and internal policies.
• Maintain a systemic view of the business, including process management, risk management, internal controls, and strategic planning.
• Work in an integrated manner with the other lines of defense, supporting business areas and periodic audits.
• Prepare executive reports for Committees and the Board of Directors.
• Lead and enhance policies, guidelines, and key performance indicators, ensuring compliance with laws and sector regulations.
• Lead the development of business rules, monitoring activities, and direct communication with COAF (Council for Financial Activities Control).
• Manage the Whistleblower/Reporting Channel, conduct internal investigations, establish action plans, and produce accurate reports.
• Assess integrity risks in processes and partners, providing input for strategic decision-making.
• Plan and execute the Annual Communication and Training Plan, developing tailored content to promote ethics at all levels.
• Monitor publications from ANS (National Supplementary Health Agency), CGU (Office of the Comptroller General), COAF and other authorities, ensuring the company remains ahead of legal requirements.
• Develop dashboards, KPIs and OKRs, as well as high-impact executive reports for Committees, Boards, and Executive Management.
• Structure the internal environment with a focus on maintaining accreditations and achieving the Pró-Ética Seal.

Compliance Specialist

• Provide support for various administrative tasks within the hospital
• Occasionally assist patients and their companions/guardians
• Provide support to physicians and their secretaries
• Handle telephone and in-person appointment scheduling
• Prepare internal control records when requested
• Receive and forward correspondence, emails, and messages
• Perform other administrative duties as directed by management

Administrative Assistant – Accounts Audit

• Validate the application of the contractual index (IPCA) according to the conditions established in the contract, performing checks and making notes when necessary.
• Conduct periodic visits to providers, focusing on operational contract monitoring and institutional relationship management.
• Support providers in liaising with headquarters, acting in low-resolution situations to restore operational flow and relationships.
• Gather and analyze provider performance indicators, focusing on billing, care profile, and service delivery, preparing comparisons and inputs for management.
• Monitor network qualification according to criteria defined by headquarters, ensuring adherence to mandatory regulations and internal guidelines.
• Execute the documentation process for new accreditations, ensuring registration and regulatory compliance.
• Perform the systematic evaluation of new accreditations according to pre-established criteria.
• Monitor the registration progress of new providers, ensuring information is up to date and consistent.
• Verify the alignment of the new provider's profile with the conditions defined by the Interchange area, reporting deviations when identified.
• Attend to providers through various communication channels, recording and tracking requests according to defined workflows.

Network Analyst

• Actively participate in creating the department, defining methodologies, policies and working tools.
• Develop the Continuous Audit program, focusing on automated monitoring and data analysis (Data Analytics).
• Plan and execute risk-based audits, prioritizing what is critical to the business.
• Implement automation and analytic intelligence solutions for deeper and more agile control testing.
• Report findings and recommendations to the Audit Committee, directly influencing senior management.
• Work closely with Compliance, Risk and IT to ensure an integrated control culture.
• Act as an ambassador for ethics, promoting training and workshops to disseminate best practices.
• Monitor action plans and area KPIs, ensuring that proposed improvements are implemented.

Internal Audit Specialist

• Ensure the organization’s operational resilience through the development, implementation and maintenance of continuity strategies.
• Ensure critical processes remain functional or are quickly recovered in the event of disruptions or crises, minimizing financial, reputational and operational impacts.
• Lead interviews and workshops to identify critical processes.
• Map threats that could disrupt the organization’s activities and provide consultative support to business areas to implement mitigation measures.
• Develop and maintain Business Continuity Plans, Crisis Management Plans and Disaster Recovery Plans, covering administrative through clinical/service areas.
• Plan and execute practical simulations to validate plan effectiveness and increase team maturity in crisis situations.
• Monitor performance KPIs and address root causes of any incidents or crises.
• Promote a culture of resilience across the company through training and capacity building.

Mid-level Business Continuity Analyst

• LGPD steward: Lead the company’s ongoing compliance with privacy and data protection regulations.
• Governance and documentation: Review and update key documents such as the Privacy Policy, Information Classification, and the data inventory (ROPA).
• Process architecture: Support the development of new policies and procedures that strengthen our data governance.
• Risk mitigation: Analyze scenarios and propose preventive measures to eliminate vulnerabilities in the processing of personal data.
• Incident response: Monitor, document and promptly act to remediate any security incident involving data.
• Data subject liaison: Serve as the focal point for handling and responding to data subject requests (LGPD rights).
• Internal advisory: Support cooperative members and employees by answering questions and advising on privacy best practices.
• Culture and awareness: Create dynamic training and awareness campaigns that make privacy a routine practice for everyone.