Hybrid Benefits Service Analyst

at Acrisure

• Job title: Benefits Service Analyst
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: No Education Requirement
• Location requirements: Hybrid, Sao Francisco do Sul, Brazil

About the role

• Analista de Atendimento de Benefícios optimizing administrative processes related to healthcare benefits. Join a motivated team focused on personalizing insurance solutions.

Responsibilities

• Provide clarifications on coverage, limits and timelines;
• Intermediary for authorizations of medical-hospital care, observing the respective requirements of the insurers/plan operators, such as DUT (Utilization Guidelines), requests to submit medical reports or complementary exams;
• Act in cases of patient transfers (removals), interacting with Itsseg medical area / insurer / client;
• Recommend medical-hospital service providers taking into account the beneficiary's plan network and the procedure to be performed;
• Advise and guide the insurer on prior reimbursement requests and reimbursement deadlines;
• Act with the client regarding any missed invoice payments and the consequent suspension of service, as reported by the insurer, Itsseg Finance or another channel;
• Monitor payment, settlement of the invoice and reactivation/unblocking of service (when applicable);
• Request extensions of due dates when the invoice was sent within the agreed timeframe;
• Direct the internal operational team regarding requests for duplicate invoices and replacement cards;
• Dispatch an Itsseg courier (when applicable) to collect/deliver documents;
• Send the checklist of documents required by the insurer to process reimbursement of medical-hospital care or reimbursement of the insured amount for group life benefits;
• Notify the client and/or follow up on return of pending documents identified or requested by the insurers in reimbursement, movement and life insurance reimbursement processes;
• Instruct on procedures in case of funeral and travel assistance;
• Respond to requests received by email within a maximum of 24 business hours from receipt;
• Record all service interactions in the Itsseg operational module;
• Immediately inform coordination of any incidents or relevant information observed during service;

Requirements

• Knowledge of Microsoft Office suite (Word, intermediate Excel);
• Essential: knowledge of benefits operational routines;

Benefits

• Health insurance;
• Dental insurance;
• Meal allowance or food voucher;
• Transportation voucher;
• Life insurance;
• Profit sharing (PLR);
• Excellent work environment — friendly, welcoming and dynamic;
• Day off on your birthday;
• Pharmacy benefits card;
• Perks club (various partnerships with exclusive discounts);
• Partnership with Sesc;
• Discounts on our products (insurance);
• Discounts on movie tickets;
• Total Pass (gym membership benefit);
• Auster — emotional balance support program;