Unimed Nacional

Bookkeeper

• Analyze hospital medical accounts, disputes, and appeal resources for denials submitted by Providers, reimbursements submitted by beneficiaries and the Unimed System, and arrange the corresponding payments, releasing the payment process to the Finance department, working under guidance;
• Verify that accounts meet regulatory requirements and comply with rules by performing checklists through the system and manual reviews, comparing and verifying amounts against tables/references, and making corrections when necessary;
• Monitor and propose changes, solutions and/or adjustments to workflows, rules in the MIN (Interchange Manual), ANS – National Supplementary Health Agency, and client portfolio invoices, aiming to improve daily processes;
• Maintain records of deliberations/assessments of processes, enter clear justifications for decision-making, check collection deadlines and the presence of signatures on deliberations generated by other areas;
• Enter and analyze provider service data and information in the system; notify any contractual modifications or system changes so that billing analyses can be closed accurately and payments ensured;
• Receive, record in spreadsheets and file invoices for medical service provision, generate analytical reports, and analyze denial appeals and medical accounts;
• Analyze requests for billing and/or rebilling submitted after deadlines, following company guidelines and responsibilities regarding acceptance and payment criteria for Unimeds, Providers and corporate clients;
• Analyze and release edits (pre-analysis rules for medical accounts in the management system) enabled for your profile, and provide support to Accredited Providers regarding account/appeal processes and other related matters when necessary.

Junior Medical Accounts Analyst – Affirmative Action Vacancy (PCD)

• Analyze hospital medical accounts, disputes, denial appeals submitted by Providers, reimbursements submitted by beneficiaries and the Unimed system, and arrange the corresponding payments, releasing the payment process to the finance department while working under guidance.
• Verify that accounts meet regulatory requirements and comply with applicable rules by performing checklists in the system and analyses, reconciling and verifying amounts according to reference tables, and taking corrective actions when necessary.
• Monitor and propose changes, solutions and/or adjustments to workflows, the MIN (Manual de Intercâmbio) rules, ANS – National Supplementary Health Agency guidelines, and client portfolio invoices to improve daily processes.
• Manage the recording of deliberations/assessments of processes, correctly enter justifications for decisions, and check billing deadlines and the existence of signatures on deliberations generated by other areas.
• Enter and analyze provider service data and information in the system, notify any contractual modifications or system changes that allow closure of billing analyses with accuracy, and ensure payment is arranged.
• Receive, spreadsheet and file medical service invoices, generate analytical reports, and analyze denial appeals and medical accounts.
• Assess requests for billing and/or rebilling submitted after deadlines, following company guidelines and responsibilities related to acceptance and payment criteria for Unimeds, Providers and companies.
• Analyze and release the "malhas" (pre-analysis rules for medical accounts in the management system) enabled for your profile, and provide support to Accredited Providers regarding Account/Appeal processes and other related matters when necessary.

Medical Accounts Analyst – Junior

Analyst

• Develop and apply stochastic and deterministic models to calculate provisions (IBNR, PEONA, PIC), using methods such as Chain Ladder, Bornhuetter-Ferguson and Cape Cod.
• Perform consistency (run-off) tests to validate the adherence and accuracy of past estimates.
• Ensure compliance with ANS requirements, with a strong focus on RN 442 and its successors.
• Work with a critical, auditable approach, ensuring the integrity and governance of databases.

Junior Medical Accounts Analyst – Affirmative Action Vacancy (PCD)

Medical Accounts Analyst – Junior

Capital and Provisions Analyst (Mid-level)