Especialista Auditoria Médica
HybridBelo Horizonte, Minas Gerais, Brazil
Job Summary
Lead technical reference for medical auditors within the Federation and Unimeds of Minas Gerais by analyzing medical documentation and claims to generate technical opinions on low, medium, and high-complexity procedures. Provide strategic advisory on ANS regulations, health legislation, and audit rules while managing partial reimbursement fund procedures and medical board processes. Conduct scientific literature reviews, arbitral hearings, and regulatory consultations, plus organize training seminars for audit teams. Represent the Federation in specialized forums to promote knowledge exchange and strengthen audit practices across the region.
Required Qualifications
- Superior Completo em Medicina
- Experiência em auditoria médica
- Conhecimento ou interesse em atuação com auditoria, regulação e saúde suplementar
Desired Qualifications
- Pós-graduação em Auditoria em Saúde ou área correlata
- Conhecimento de sistemas e ferramentas utilizados nas rotinas de auditoria e regulação em saúde
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