Enfermeiro(a) Auditor | Central de Autorização Pré | Hospital Rio Barra
On-siteRio de Janeiro, Rio de Janeiro, Brazil
Job Summary
Indicate services to be charged on hospital accounts and request authorizations for materials, medications, and special procedures to validate correct billing. Establish partnerships with the multidisciplinary team to resolve identified issues in medical orders. Analyze surgical documentation, OPME sheets, and anesthesia records to evaluate quality, technical pertinence, and commercial rules. Fill pending item checklists for account returns, contra-audit medical accounts with various insurance plans, and audit surgical processes. Validate provisional and permanent materials, request material registrations, participate in payment negotiations, and check the surgical map daily. Full nursing degree required with active Coren; flexible day/night shifts available.
Required Qualifications
- Superior completo em Enfermagem
- Coren ativo e dentro da validade
- Trabalhar com diferentes escalas (diurno e/ou noturno)
- Ter disponibilidade para treinamento inicial em horário comercial
Desired Qualifications
- Pós graduação em áreas afins
- Conhecimento de tabelas TUSS
- Conhecimento de revistas farmacêuticas BRASINDICE
- Conhecimento de revistas farmacêuticas SIMPRO
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