Medical Accounts Analyst – Junior

Role Overview

• Analyze hospital medical accounts, disputes, denial appeals submitted by Providers, reimbursements submitted by beneficiaries and the Unimed system, and arrange the corresponding payments, releasing the payment process to the finance department while working under guidance.
• Verify that accounts meet regulatory requirements and comply with applicable rules by performing checklists in the system and analyses, reconciling and verifying amounts according to reference tables, and taking corrective actions when necessary.
• Monitor and propose changes, solutions and/or adjustments to workflows, the MIN (Manual de Intercâmbio) rules, ANS – National Supplementary Health Agency guidelines, and client portfolio invoices to improve daily processes.
• Manage the recording of deliberations/assessments of processes, correctly enter justifications for decisions, and check billing deadlines and the existence of signatures on deliberations generated by other areas.
• Enter and analyze provider service data and information in the system, notify any contractual modifications or system changes that allow closure of billing analyses with accuracy, and ensure payment is arranged.
• Receive, spreadsheet and file medical service invoices, generate analytical reports, and analyze denial appeals and medical accounts.
• Assess requests for billing and/or rebilling submitted after deadlines, following company guidelines and responsibilities related to acceptance and payment criteria for Unimeds, Providers and companies.
• Analyze and release the "malhas" (pre-analysis rules for medical accounts in the management system) enabled for your profile, and provide support to Accredited Providers regarding Account/Appeal processes and other related matters when necessary.

Requirements

• Bachelor’s degree in Business Administration, Accounting, Economics or a related field.
• Experience in the area.
• Proficiency in Excel.

Benefits

• Medical Plan: Outpatient, hospital and obstetrics coverage for you and your legal dependents.
• Dental Plan: Company-subsidized plans covering basic procedures up to orthodontics and prosthetics.
• Pharmacy Agreement: Access to discounted medication purchases at participating pharmacies with payroll deduction and a salary-based limit.
• Wellhub (Gympass): Wellbeing platform with access to gyms and health apps, extendable to up to 3 dependents.
• Meal Card: Daily amount credited for working days to cover meals.
• Grocery Card: Monthly credit to assist with grocery purchases.
• Private Pension Plan: Company-established plan to help build financial reserves and future income.
• Life Insurance: Coverage for death and disability, providing financial protection for you and your family.
• PPR (Results Participation Program): Annual reward based on achieving the cooperative’s collective goals.
• Commuter Allowance: Available for travel between home and work in on-site or hybrid arrangements.
• Parking: Agreements with parking networks near company facilities.
• Day Off: One day off granted after your birthday for you to use as you prefer.
• Family Support: Daycare or nanny subsidy for employees with children up to 16 months.
• Perks Club: Partnerships and discounts with educational institutions, language schools and leisure providers.