Senior Digital Auditor at GE HealthCare conducting data privacy assessments and ensuring compliance with regulations like GDPR. Collaborating with teams to improve privacy controls and audit readiness.
About the role
- Auditor de Saúde II na Unimed, responsável por auditoria técnica e gerenciamento de contas médicas. Foco em conformidade ética e otimização de custos.
Responsibilities
- Perform technical audits of medical and hospital claims/accounts
- Ensure cost control and sustainable management of claims (loss ratio)
- Ensure ethical and regulatory compliance
Requirements
- Medical degree (MD) with active registration in the Regional Medical Council (CRM)
- Preferred: postgraduate degree or specialization in Health Audit, Health Services Management, or related fields
Benefits
- Commitment to diversity and inclusion across all roles
- Hybrid work
- Analysis of claim forms and procedures (SADT and surgeries) and assessment of the appropriateness of materials/OPME
- Billing audit, application of claim denials/adjustments (glosas), and validation of fee schedules and contracts
- Strict management of ANS (Brazilian National Supplementary Health Agency) deadlines and compliance with regulatory standards
- Development of performance indicators and management reports to support decision-making
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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