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The HartfordPremium Auditor
Premium Auditor performing annual virtual reviews of policyholder's payroll and financial records. Maintaining customer relationships and identifying classification factors for insurability.
About the role
- Realizar auditoria de contas médicas e procedimentos, analisando materiais utilizados e respectivos valores
- Confrontar pedido médico, notas fiscais e elegibilidade da guia
- Auditar Serviços Ambulatoriais de Apoio Diagnóstico e Terapêutico e efetuar glosas quando necessário
- Analisar guias item a item, aprovando autorizações ou definindo glosas
- Revisar e avaliar conformidade de registros e procedimentos conforme normas e legislação
- Desenvolver estudos, compilar informações e apresentar indicadores para gestão de liberações e análises financeiras
- Checar pedidos conforme prazos da ANS e controlar liberação de prazos
- Executar e auditar faturamento de contas hospitalares usando contratos, tabelas acordadas e cálculos
- Relacionar informações de cirurgias solicitadas, gerar relatórios e controlar fluxo de liberação
Requirements
- Superior em Medicina
- Registro no CRM
- Desejável pós-graduação em gestão de serviços de saúde
- Disponibilidade para carga horária de 8 horas, segunda a sexta-feira
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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