This is an on-site, full-time position in the Rio Comprido neighborhood, in Rio de Janeiro (RJ). Hiring is under a CLT contract, at junior level, with a salary of R$ 2,611 and 2 open positions.
Accrua is the AI-native operating system for hospitals: we run the private healthcare revenue cycle end to end, with artificial intelligence agents and specialists, to give hospitals back the revenue that is rightfully theirs.
We are looking for an analytical, detail-oriented, proactive person committed to the accuracy and compliance of medical bills to join Accrua's denial appeals team.
Role mission
Ensure that the care delivered by the hospitals we serve is properly recognized by health plans, analyzing, disputing and recovering denials with accuracy and speed, supported by Accrua's AI technology.
Main responsibilities
- Review denial appeals, examining medical documentation and care records to assess the validity of disputes and identify errors or gaps.
- Work with hospital billing, audit and coding teams to obtain clarification on procedures performed.
- Interact with health plans to discuss and negotiate disputed denials, with well-founded arguments and proper documentation.
- Investigate the causes of denials and propose corrective actions to prevent recurrence.
- Prepare and review appeal documentation, ensuring compliance with contracts and payer requirements.
- Analyze denial patterns and trends, supporting the evolution of Accrua's AI models and agents.
Requirements
- Bachelor's degree in Business Administration, Accounting or Health Sciences.
- At least 2 years of experience in healthcare.
- Microsoft Office, with intermediate Excel.
- Analytical and problem-solving skills.
Nice to have
- Specialization in Hospital Administration.
- Knowledge of hospital management and billing systems, such as MV Soul and MV 2000.