Hybrid Junior Nurse — Medical Claims Auditor

Posted 16 hours ago

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About the role

  • Junior Medical Auditor at Sami analyzing medical accounts and ensuring compliance with healthcare regulations. Collaborating with teams to improve healthcare services and processes.

Responsibilities

  • Analyze medical, hospital and outpatient accounts in accordance with the health plan's policies and guidelines.
  • Evaluate clinical records, medical charts and procedures performed.
  • Verify coding according to billing tables (TUSS, AMB, CBHPM, among others).
  • Identify inconsistencies, billing errors and opportunities for improvement.
  • Prepare technical assessments and audit reports.
  • Interact with internal teams, providers and hospitals to obtain clarifications.

Requirements

  • Bachelor's degree in Nursing with postgraduate specialization in Health Audit.
  • Strong knowledge of AMB, CBHPM, TUSS and TISS tables/systems.
  • Understanding of medical claims concepts and processes, and health regulation.
  • Proficient in Microsoft Office Suite.

Benefits

  • 🏥 Private health insurance.
  • 🦷 Dental insurance.
  • 🍲 Flexible meal/food allowance loaded on a Flash card.
  • 💻 Monthly remote work allowance.
  • ‍🍼 Childcare assistance for Sami mothers.
  • 🪑 Allowance for purchasing an office chair.
  • 🎂 Birthday day off.
  • 🤰 Six months maternity leave and 20 days paternity leave.
  • 🏋️‍♀️ Wellhub (Gympass) — partnerships with gyms nationwide at attractive rates.
  • 🧠 Wellz — weekly therapy and mental health resources.
  • 📚 Sami Hub — development platform with over 100 courses to support your growth.

Job title

Junior Nurse — Medical Claims Auditor

Job type

Experience level

Junior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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