LogoFresh Jobs Ahead
Hospitalcare Products Co.
Hospitalcare Products Co.
1 – 10 Angajați
Asistență medicalăB2BIndustria prelucrătoare
Hospitalcare Products Co. distribuie consumabile și echipamente medicale către unități de asistență medicală. Activând în sectorul fabricării echipamentelor medicale, compania îi ajută pe furnizori să procure produsele esențiale pentru îngrijirea și activitatea lor de zi cu zi.
LinkedIn
Locurile de muncă ale companiei

Nurse Auditor, Denial Management

Review claim denials, contracts, and financial indicators at Hospital Care. Help hospitals and operational teams recover revenue and reduce losses.

BRBraziliaHibridNormă întreagăNivel mediuSeniorLimbă Obligatorie: portughezăAuditor

Descriere

  • Analyze initial claim denials to identify causes, trends, and financial impact.
  • Break down denials by insurer, hospital, specialty, process, and reason.
  • Check clinical, administrative, and billing processes against contracts, fee schedules, billing rules, and regulations.
  • Find opportunities to recover revenue and limit recurring losses.
  • Lead root cause reviews using methods such as 5 Whys, Ishikawa, GUT, RCA, and Pareto.
  • Help operations, billing, concurrent review, and appeals teams interpret insurers’ findings.
  • Track denial performance indicators and identify areas for improvement.
  • Prepare executive reports, dashboards, and presentations to inform decisions.
  • Join corporate meetings with hospital units and multidisciplinary teams to review results and action plans.
  • Advise on clinical rules, contracts, and insurers’ audit criteria.
  • Recommend preventive and corrective measures to reduce repeat denials.
  • Support other Revenue Cycle teams as needed by the department.

Cerințe

  • Degree in Healthcare Auditing or a related field.
  • Knowledge of hospital revenue cycles and claims auditing.
  • Experience with denial management and appeals.
  • Ability to use AI tools.
  • Knowledge of health insurance contracts and reimbursement rules.
  • Familiarity with TUSS, CBHPM, SIMPRO, and BRASÍNDICE fee schedules.
  • Ability to interpret clinical and financial indicators.
  • Knowledge of root cause analysis tools.
  • Basic proficiency in advanced Excel.
  • Experience with hospital information systems such as MV, Tasy, or equivalent.

Beneficii

  • Meal and food allowance through the Pluxee (Sodexo) multi-benefit card.
  • Transportation allowance provided on a card.
  • Health insurance through 2Care Vera Cruz Campinas, including dependents.
  • Amil Dental coverage, including dependents.
  • Childcare assistance for female HC employees with children up to age 6.
  • Life insurance.
  • Wellhub (Gympass) membership, including dependents.
  • SESC partnership, including dependents.
  • Profit-sharing.
  • Financial assistance for courses.
  • Training platform.

Locuri de muncă similare

Peraton

Peraton Director of Business Development, Defense Intelligence

Peraton
Sponsor pentru viza H1BAsistență medicalăConsultanțăLogistică
USStatele Unite ale AmericiiALAlabamaVAVirginia
176.000 $ – 282.000 $ / an
La sediuNormă întreagăLiderLimbă Obligatorie: englezăReprezentant dezvoltare afaceri
TypeScript

Lead business development for Peraton’s DIA portfolio, shaping defense intelligence opportunities and guiding complex pursuits. Build strategic customer relationships and grow the pipeline across intelligence and defense organizations.

Deschide
Kpler

Commodities Account Manager – Kpler, Dubai Hybrid

Kpler
201 – 500 Angajați
Sponsor pentru viza H1BAsistență medicalăConsultanțăLogistică
AEEmiratele Arabe UniteHibridNormă întreagăNivel mediuSeniorLimbă Obligatorie: arabăLimbă Obligatorie: englezăManager de conturiVânzări

Grow Kpler’s commodities intelligence business across the Middle East and Africa by managing strategic accounts. Lead renewals, negotiations, and expansion opportunities for its trade intelligence platform.

Deschide