Sírio-Libanês is seeking a Medical Auditor (Médico(a) Auditor) to manage financial and administrative interactions with health plan operators. You will be responsible for ensuring accurate billing, coordinating with clinical teams, and securing necessary authorizations, playing a key role in our healthcare operations.
What You'll Do
- Negotiate hospital accounts with auditors from health plan operators.
- Coordinate with internal and multidisciplinary teams regarding questions about hospital bill postings and medical record entries.
- Engage the clinical staff to obtain medical reports when requested by the health plan's medical audit.
- Provide information to care areas regarding any queries from health plan operators.
- Negotiate authorizations for surgical and clinical procedures with health plan auditors and provide reports as needed.
What We're Looking For
- Graduation in Medicine.
- Specialist title/certification by the AMB and/or RQE.
- Knowledge of the following tables: SIMPRO/AMB/CIEFAS/APAMO/BRASÍNDICE/CBHPM/TISS/TUSS.
- Experience in negotiation with health plan operators and hospital accounts.
Nice to Have
- Postgraduate degree in Auditing is considered a plus.
Benefits & Compensation
- Healthcare Coverage
- Cuidando de Quem Cuida Program
- Dental Assistance
- Pharmacy Agreement
- Life Insurance
- Daycare Assistance
- Vaccine Discount
- Recarrega Program
- Gym Membership Agreement
- Food Voucher
- Home-Office Allowance
- Benefits Club (partnerships and promotions)
- Transportation Voucher
Work Mode
This is a hybrid position based at our Bela Vista Unit.
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