Página da Vaga | Analista de Contas Médicas Jr - Gestão de Contas - Ibirapuera

AACD; São Paulo; Presencial; BRL 20.000 - 40.000; Tempo integral

Resumo da oferta

An established industry player is seeking a detail-oriented professional to manage hospital medical service accounts. This role involves verifying authorizations, validating invoices, and ensuring accurate billing processes. You will engage with various departments to streamline operations and prevent billing discrepancies. The company offers a supportive environment with numerous benefits, including medical assistance and educational partnerships. If you are passionate about healthcare administration and eager to contribute to a vital sector, this opportunity is perfect for you.

Serviços

Medical Assistance

Dental Assistance

Transportation Voucher

Life Insurance

On-site cafeteria

Childcare Assistance

Breakfast

Medical outpatient services

Wellhub

Birthday day off

Qualificações

• Currently pursuing or completed higher education in Business Administration or related fields.
• Knowledge of AMB Tables, CIEFAS, SIMPRO, BRASÍNDICE, TUSS, and SIGTAP is necessary.

Responsabilidades

• Verify/Validate authorizations, invoices, medical fees, and procedures.
• Support related sectors regarding billing issues and generate electronic/XML files.
• Engage with all involved areas to gather information for account preparation.

Conhecimentos

Business Administration

Knowledge of AMB Tables

Knowledge of CIEFAS

Knowledge of SIMPRO

Knowledge of BRASÍNDICE

Knowledge of TUSS

Knowledge of SIGTAP

Microsoft Office Suite

Formação académica

Higher Education in Business Administration

Descrição da oferta de emprego

Job description

Analyze all relevant documentation related to hospital medical service accounts to enable billing processes.

Main responsibilities

1. Verify/Validate authorizations, invoices, medical fees, daily rates, taxes, hemotherapies, procedures, SADTs, packages, exams, meals, special materials (OPME);
2. Enter corrections to accounts analyzed by Medical Audit into the system;
3. Inform related departments about missing authorizations and/or necessary documentation for billing;
4. Monitor approved accounts through pending account reports to verify status;
5. Begin account analysis using digital medical records;
6. Support related sectors regarding billing issues, such as Glosas appeals, finance, accounting, authorization center, OPME, and inpatient units;
7. Perform cross-checks of all information in the patient's records;
8. Generate electronic/XML files and send them on operator and health plan platforms;
9. Create invoices;
10. Support or prepare delivery, scan, or copy accounts and send to operators and health plans, ensuring signed protocols are returned via transportation when necessary;
11. Ensure billing submission with accurate information as per contracts and delivery schedules agreed with health operators/plans;
12. Analyze SUS accounts, SIGTAP table, SUS billing, and send XML/GRD files to municipal health authorities;
13. Engage with all involved areas to gather information and documents necessary for account preparation and to promote best practices to prevent future glosas;
14. Generate Repasses;
15. Analyze medical Repasses to ensure payment of HMs as per contract;
16. Create provisions for accounting;
17. Reconcile Repasses with accounting records;
18. Manage medical Repasses, fixed payments, CDI payments, external provider payments, on-call payments, FUMCAD payments, variable remuneration, and medical scoring programs;
19. Handle reimbursements between the hospital and the operator;
20. Verify pending payments;
21. Register suppliers in the system;
22. Deduct glosas;
23. Mediate negotiations between the hospital and the agreement for collection of supplementary HMs;
24. Register and maintain rules for Repasses in the system;
25. Provide internal and external customer service;
26. Send payment statements to doctors and/or secretariats;
27. Receive invoices and enter them into the system;
28. Collect authorizations/signatures for payments.

Requirements and skills

• Currently pursuing or completed higher education in Business Administration or related fields;
• Knowledge of AMB Tables, CIEFAS, SIMPRO, BRASÍNDICE, TUSS, and SIGTAP is necessary;
• Basic knowledge of Microsoft Office Suite is desirable.

Additional information

What benefits do we offer our employees?

• Medical Assistance
• Dental Assistance
• Transportation Voucher
• Life Insurance
• On-site cafeteria
• Childcare Assistance*
• Breakfast
• Medical outpatient services
• Wellhub
• Birthday day off
• Christmas basket or voucher
• Quality of Life initiatives
• We + Health Program
• Payroll Loan
• Service awards for longevity
• Educational partnerships
• AACD Club
• Pharmacy partnerships

*For women with children as per collective agreement.