Discover a career with greater purpose

Accurate Health Auditing & Consulting Single Member S.A., a subsidiary of the IQVIA Group and a premier provider of medical audit, Third Party Administration (TPA) and consulting services in the healthcare sector, operating both domestically and internationally, is seeking Administrative Employees for its Claims Management Department. This role is integral to our collaboration with Insurance Companies and Insurance Funds.

Position Highlights

• Provide excellent TPA services to insurance companies with reliability and accuracy.
• Manage new admissions, enter insured data, locate insured individuals through insurance systems (when required), and complete relevant forms in the electronic system.
• Review cases, verify prices of billed services based on agreed price lists between insurance companies and hospitals, and calculate fees for treating physicians.
• Informe Accurate Audit Units of any changes in discharge checks (omissions, corrections, registration of medical documents), as identified during departmental audits.
• Notify insurance companies of hospitalizations by electronically sending all relevant documents.
• Conduct daily reviews of aggregated case lists per Hospital.
• Communicate the final opinion of the Medical Auditor to insurance companies and hospitals in detail.
• Collaborate with medical staff to adhere to timelines and clinic workflow.
• Issue interim and/or final guarantees, complete bordereau files and other reports for insurance companies.
• Manage hospital submission.
• Handle email correspondence with insurance companies and hospitals.

Required Qualifications:

• University or Technological Educational Institute degree.
• Proficiency in computer applications (Excel, Word, Outlook, Power Point) and internet usage.
• Strong written and oral communication skills, effective time management and teamwork abilities.

Desired Qualifications:

• Background in health studies.
• Good knowledge of English.
• Previous experience in the healthcare industry, insurance market or consulting services.

What we offer:

• Salary based on qualifications.
• Opportunities for professional development.
• Indefinite contract (five-day, eight-hour employment).

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com