Junior Medical Accounts Analyst – Affirmative Action Vacancy (PCD)

Role Overview

• Analyze hospital medical accounts, disputes, and appeal resources for denials submitted by Providers, reimbursements submitted by beneficiaries and the Unimed System, and arrange the corresponding payments, releasing the payment process to the Finance department, working under guidance;
• Verify that accounts meet regulatory requirements and comply with rules by performing checklists through the system and manual reviews, comparing and verifying amounts against tables/references, and making corrections when necessary;
• Monitor and propose changes, solutions and/or adjustments to workflows, rules in the MIN (Interchange Manual), ANS – National Supplementary Health Agency, and client portfolio invoices, aiming to improve daily processes;
• Maintain records of deliberations/assessments of processes, enter clear justifications for decision-making, check collection deadlines and the presence 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 so that billing analyses can be closed accurately and payments ensured;
• Receive, record in spreadsheets and file invoices for medical service provision, generate analytical reports, and analyze denial appeals and medical accounts;
• Analyze requests for billing and/or rebilling submitted after deadlines, following company guidelines and responsibilities regarding acceptance and payment criteria for Unimeds, Providers and corporate clients;
• Analyze and release edits (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 related fields;
• Experience in the area;
• Proficiency in Excel.

Benefits

• Medical Insurance: Outpatient, hospital and obstetric coverage for you and your legal dependents.
• Dental Plan: Company-subsidized plans covering basic procedures up to orthodontics and prosthetics.
• Pharmacy Agreement: Convenience for purchasing medications at accredited pharmacies with payroll discount and an allowance based on salary.
• Wellhub (Gympass): Wellbeing platform providing access to gyms and health apps, extendable to up to 3 dependents.
• Meal Card: Daily allowance credited for workdays to cover meals.
• Food Card: Monthly credit provided to assist with grocery purchases.
• Private Pension: Company-sponsored 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 (Profit Sharing Program): Annual reward based on achieving the cooperative’s collective goals.
• Commuter Allowance: Available for travel between home and workplace in onsite or hybrid arrangements.
• Parking: Agreements with parking networks near the company’s sites.
• Day Off: One day off granted after your birthday for you to use as you wish.
• Family Support: Daycare or nanny assistance for female employees with children up to 16 months old.
• Benefits Club: Partnerships and discounts with educational institutions, language schools and leisure options.