Assistente de Serviços para Clientes

Provide top-notch customer service to clients and healthcare providers for scheduling and authorization of consultations and exams.

• Attend beneficiaries for release of exam and procedure authorizations in the credentialed network and own resources, upon medical request and contract coverage consultation;
• Issue attendance protocol in person;
• Perform exam scheduling in our own resources;
• Evaluate the need for reports for the requested procedure and analysis of audit;
• Consult the procedure informed by the doctor if it is foreseen in the ANS Role, and give follow-up on authorization;
• Consult the client's financial position in the internal system and print invoices;
• Consult the system for addresses of credentialed clinics and consultorios for beneficiary information;
• Digitalize documents to attach to exam and surgery requests pending;
• Forward authorization process requests to the Cost Assistance Department for analysis;
• Release admission and periodic exams (PCMSO);
• Release exam and surgery guides that pass through medical audit analysis with exchange password or location;
• Prioritize clients waiting for in-person attendance;
• Provide in-person attendance to clients, record SAC (customer service) and ombudsman in the management system and forward to SAC;
• Contact clients to inform if the procedure was denied;
• Know and use the Unimed Brazil Intercambio Manual to request beneficiary authorizations;
• Contact Unimeds and providers via chat or phone to apply intercambio rules, collect deadlines determined by Unimed do Brasil;
• Request early password for the client who will perform the procedure outside their contract area;
• Request authorization for intercambio client through Unimed do Brasil integrated system for Unimed Origin;
• Create client and exam records in the TASY system;
• Instruct clients on preparation for exam performance;
• Request relevant information from clients regarding medication, habits, etc. to assist the clinical analyst during analysis;
• Apply client satisfaction surveys to all clients;
• Follow laboratory protocols described in the manual;
• Verify previously scheduled appointments;
• Consult eligibility for beneficiary attendance;
• Open attendance with documents and update beneficiary register;
• Schedule consultations, exams or procedures according to patient needs or doctor guidance;
• Deliver preventive and laboratorial exam reports and ECG image performed in the office;
• Send exams from other nuclei for delivery;
• Print medical production for subsequent signature by the beneficiary, and all material pertinent to the activity;
• Make available the declaration of attendance to the beneficiary when requested;
• Keep work station organized;
• Contact doctors or professionals as needed for complementary activities for beneficiary attendance;
• Send daily production to billing;
• Check daily pending accounts received from billing;
• Make available suitable containers for requested lab collections;
• Schedule periodic patient follow-ups in therapy, or schedule return as per professional guidance;
• Schedule consultations requested by other nuclei (with multi-professional team);
• Schedule appointments as per patient need or doctor guidance;
• Autorize scheduled procedures;
• Autorize requests delivered by the beneficiary for exams and procedures in the owned or credentialed network;
• Make available medical guide for beneficiary information;
• Consult the procedure code informed by the doctor if it is foreseen in the ANS Role for follow-up on authorization;
• Digitalize documents to attach to pending exam and surgery requests;
• Send requests for authorization process to the Cost Assistance Department for analysis;