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About the role
Key responsibilities & impact- Perform operational tasks using the information tools and systems of Unimed Porto Alegre, the Unimed System, and other necessary systems;
- Initiate and respond to contacts with internal and external clients related to the process, aiming to enable alignment and problem resolution within the cooperative and the Unimed system;
- Analyze client complaints received that relate to audit processes;
- Interact with other audit professionals (physicians, nurses, administrative staff, pharmacists, social workers, speech therapists, and psychologists);
- Receive, control, and digitize documents submitted by providers, sorting and filing them afterward;
- Analyze and validate system denials (glosas) according to payment and non-payment rules;
- Conduct audits to identify opportunities for alignment in hospital and Unimed processes, seeking to enhance their training and capabilities;
- Audit medical and hospital expense charges submitted by the Unimed System and hospitals, with a care-focused perspective, assessing whether they comply with current rules and agreements;
- Perform data entry, adjustments, or credits of healthcare accounts;
- Populate, generate, review, and print control spreadsheets and reports, correcting any errors;
- Monitor and meet deadlines and process indicators, and act proactively to resolve issues;
- Serve as a communication facilitator with the Unimed System, ensuring process agility.
Requirements
What you’ll need- Education required for this position: High school diploma.
- Proficiency in Excel.
- Previous experience in auditing or hospital billing.
- Knowledge of the TOTVS system.
- Higher education in progress or completed (Administration, Management Processes, Healthcare Management, or related fields) is a plus.
Benefits
Comp & perks- Position also open to candidates with disabilities (PwD)
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
auditinghospital billingdata entrydocument controlprocess analysissystem validationreport generationExcelpayment ruleshealthcare accounts
Soft Skills
communicationproblem resolutionproactiveorganizationalinterpersonalalignment facilitationdeadline management