Médico Auditor Reumatologista – Auditoria Prévia

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

📋 Description

• Assessment of eligibility and authorization of medical procedures by health plans through an online system.

• Conduct prospective audits (technical regulation).

• Communicate in writing to the appropriate parties your observations, conclusions, and recommendations after analyzing guidelines.

• Issue technical opinions within your area of expertise.

• Request reports from the audited parties when necessary.

• Operate impartially in the issuance of reports and technical opinions.

⛳️ Requirements

• Completed higher education in Medicine.

• Postgraduate specialization in Rheumatology.

• Active and regular registration with the CRM.

• Proven experience in Prospective Auditing.

• Solid knowledge of medical guidelines, procedures, AMB remuneration tables, and TUSS terminology.

• Proficiency in Microsoft Office Suite.

• Ethical declaration.

• Experience in multidisciplinary team collaborations.

• Experience in a health plan operator.

• Postgraduate specialization in auditing.

• Familiarity with ANS regulations, technical opinions, and health plan policies.

🏝️ Benefits

• Competitive salary package.

• Opportunities for professional development.

• Collaborative work environment.

• Health and wellness programs.