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.
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