Analyst managing internal processes for SUS reimbursement and ensuring documentation validity. Support decision-making and compliance with regulatory standards.
Responsibilities
Standardize and regulate internal processes related to handling SUS (Unified Health System) reimbursement requests, ensuring correct case preparation to effectively defend the operator before the National Supplementary Health Agency (ANS), based on normative instructions, ordinances and other applicable regulations in force at the time, within the deadline established by the agency.
Receive, triage and organize documentation (GRU, medical records, contracts, receipts, etc.) related to reimbursement notifications sent by ANS.
Create digital files, update the control system (Top Saúde RESUS) and ensure the completeness and validity of documents.
Rigorously monitor first- and second-instance deadlines, coordinate data collection with internal areas (Medical, Legal, Finance) and ensure information is ready for external defense.
Control payments made to the regulatory agency (ANS).
Provide support to the Mid/Senior Analyst by preparing control reports and dashboards.
Identify, manage and mitigate risks, proposing solutions that have business impact.
Propose, follow up and validate improvements to systems and area workflows.
Attend internal and external audits and ensure compliance with ANS regulations, quality standards and internal procedures.
Requirements
Bachelor's degree in Business Administration, Hospital Administration or a related field.
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