Medical Auditor

This is a fully remote position, open to applicants in Brazil.

📋 Description

• Conduct technical utilization assessments of medical procedures, evaluating requests according to current clinical and regulatory standards using the company’s proprietary system.

• Provide well-founded technical opinions for authorizations and requests related to elective, urgent, and emergency procedures.

• Ensure compliance and quality in reviews while responding effectively to operational demands.

• Carry out all tasks remotely, with availability during standard business hours.

• Contribute to the sustainability of healthcare operations and excellence in patient care.

⛳️ Requirements

• Bachelor’s degree in Medicine.

• Active and unrestricted registration with the relevant medical board (CRM), including the submission of a certificate of good standing from the professional council.

• Completed postgraduate qualification in Medical Auditing.

• At least two (2) years of documented professional experience in medical auditing.

• Relevant and diverse clinical experience across various medical specialties.

• Strong understanding of medical guidelines, procedures, reimbursement tables (e.g., AMB), and TUSS terminology.

• Basic computer skills and familiarity with management systems.

• Strong analytical abilities to critically, impartially, and decisively review medical information.

• Commitment to ethics and stringent confidentiality when managing sensitive information and patient medical records.

• Excellent capability to manage deadlines and priorities in a dynamic environment, demonstrating discipline and a strong professional commitment in a remote context.

• Ability to work effectively in teams and collaborate constructively with other healthcare professionals.

• Extensive knowledge of ANS (Brazil’s National Supplementary Health Agency) regulations and standards.

• Solid expertise in preparing technical opinions and operational policies for health plans.

🏝️ Benefits

• Comprehensive health insurance coverage.

• Flexible work hours and the option to work remotely.

• Opportunities for professional development and continuous education.

• Supportive team environment and collaborative culture.