Medical Auditor, Orthopedist

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

📋 Description

• Conduct technical regulation of medical requests within health plans and agreements with service providers.

• Provide specialized technical opinions and carry out medical audit analyses focused on Orthopedics and Spine Surgery.

• Evaluate requests submitted by clients.

• Offer technical support for the establishment of Medical Boards (Juntas Médicas).

• Deliver services and perform activities during business hours, operating fully remotely (home office).

⛳️ Requirements

• Completed medical degree.

• Active and valid registration with the regional Medical Council (CRM), including the submission of a 'Nada Consta' (no-record) letter from the professional council.

• Current Specialist Qualification Registration (RQE) in Orthopedics or Spine Surgery.

• Completed postgraduate degree in Medical Auditing.

• A minimum of 2 (two) years of demonstrated professional experience in auditing.

• Relevant and established clinical experience in Orthopedics/Spine Surgery.

• Strong knowledge of medical guidelines, procedures, fee schedules (e.g., AMB), and TUSS terminology.

• Basic computer skills with a strong professional commitment to self-manage remote work tasks.

• Practice guided by ethics and strict confidentiality in managing sensitive patient information.

• Excellent communication skills (both verbal and written), with the ability to manage deadlines/priorities and work effectively in a team.

• Extensive familiarity with the regulation of OPME (Orthoses, Prostheses, and Special Materials) commonly used in Orthopedics and Spine Surgery.

• Strong knowledge and understanding of ANS (National Supplementary Health Agency) regulations, technical opinions, and health plan policies.

• High analytical capability to critically, impartially, and decisively review medical and procedural information.

🏝️ Benefits

• Competitive salary package.

• Flexible working hours.

• Opportunities for professional development and training.

• Supportive work environment that fosters collaboration.