• Você atuará como profissional autônomo com as seguintes atribuições: • Inicialmente, se dedicará exclusivamente ao curso preparatório da MAG Universidade para obtenção da habilitação técnico profissional junto a Susep; • Após a conquista da Habilitação: • Identificará potenciais clientes para abordar, utilizando sua Rede de Relacionamento para agendamento de entrevistas de vendas e solicitação de indicações; • Fará telemarketing ativo para agendar entrevistas de vendas; • Realizará as entrevistas de vendas, identificando as necessidades de proteção financeira do prospect e ofertando as soluções mais adequadas a cada perfil; • Gerenciará a sua carteira de clientes com foco na sustentabilidade financeira do seu negócio.

Role Description The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. - Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. - The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies. - Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses. - Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations. - Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues. - Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results. - Provide clinical and strategic input when participating in organizational committees, projects, and task forces. Qualifications - MD or DO with an active, unrestricted license. - Board Certified in an ABMS or AOBMS specialty. - 5+ years clinical practice experience. - 2+ years of Quality Management experience. - Intermediate or higher level of proficiency with managed care. - Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. - Internet researching skills. - Proven excellent telephonic communication skills; excellent interpersonal communication skills. - Proven excellent project management skills. - Proven data analysis and interpretation skills. - Proven excellent presentation skills for both clinical and non-clinical audiences. - Familiarity with current medical issues and practices. - Proven creative problem-solving skills. - Proven solid team player and team building skills. Requirements - Compensation for this specialty generally ranges from $248,500 - $373,000. - Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. - We comply with all minimum wage laws as applicable. - In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). Benefits - A far-reaching choice of benefits and incentives. Company Description At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. - UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. - UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Role Description Cranial Technologies is looking for a full-time Insurance Verification Specialist to join our customer-focused team! This position plays an integral role in the patient and family experience by expediting the insurance process while maintaining a high level of professional communication. This person will efficiently compile benefits, eligibility, criteria, and prior authorization requirements for multiple insurance companies throughout the country as it relates to the DOC Band and Earwell treatments. We’re looking for someone who can thoroughly research and pinpoint the critical insurance answers our Insurance Liaison team needs to implement the insurance process for families. Our ideal candidate is self-motivated and enjoys both collaborating with a team of passionate individuals and completing a high volume of tasks each day in a dynamic work-from-home environment. They love learning new things in a fast-paced, ever-evolving company. We’re looking for someone who enjoys solving problems with a high sense of urgency to ensure our insurance process is as efficient as possible. Responsibilities include: - Research, review, and effectively document benefits, eligibility, and authorization requirements within our system - Coordination of information between referring physicians, insurance companies, and our own treatment clinics - Partner with internal departments and external payors with a high level of professional communication and efficiency - Calculate and communicate cost shares, co-payments, and financial responsibilities with the Insurance Liaison team, so they may provide the information to our patients and their families - Complete 35-50 verification tasks per day with a high level of accuracy Qualifications - 1 – 2 years of internal and/or external professional communication - 1 – 2 years’ experience with computer software such as Microsoft Outlook and Adobe - Investigative, curious, and problem-solving mindset - Strong organizational skills and attention to detail - Self-motivated, task-oriented mindset with a strong ability to multi-task - Professional verbal and written communication style with team members and payors - Ability to work on a team as well independently - Ability to learn new things and apply them in a fast-paced, ever-evolving environment Benefits - Medical, Vision, and Dental Insurance - 401k Retirement Plan - 18 Days Paid Time Off each year plus 7 company-paid Holidays - Life Insurance - Short/Long Term Disability Insurance - Opportunity for performance-based bonuses Compensation The pay range for this position is $17 - $18 per hour. Pay is dependent on the applicant's relevant experience. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. You will receive a confirmation email stating your application has been submitted. Once your application has been reviewed, you should receive an update on your status via email. Please keep an eye on your spam and junk mail . Please no phone calls to the clinic or offices regarding the position. If you are unable to submit your application, please email the recruiting department at careers@cranialtech.com for assistance. #LI-Remote

Role Description We are seeking an experienced Healthcare Virtual Assistant to support a busy vascular surgery practice with prior authorizations, insurance verification, referrals, patient estimates, and medical records coordination. This role requires someone who can work independently, think critically, and manage multiple time-sensitive requests while maintaining accuracy and professionalism. The ideal candidate has extensive experience working with U.S. healthcare practices and is highly skilled in: - Authorization workflows - Insurance verification - CPT coding review - Clinical documentation support Core Responsibilities - Prior Authorization Management (Top Priority) - Manage prior authorizations for vascular surgery procedures - Submit and track radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) - Monitor authorization requests and update CPT codes when procedures change - Prepare and submit authorization letters and supporting documentation - Communicate with insurance companies regarding approvals, denials, modifications, and status updates - Manage TriWest and Veteran authorization requests - Review patient charts and gather supporting clinical documentation for insurance submissions - Collaborate with providers and nurses to obtain missing clinical information - Insurance Verification, Referrals & Patient Estimates (Top Priority) - Verify insurance eligibility and patient benefits - Handle HMO referrals and referral follow-ups - Review patient notes and identify appropriate CPT codes - Generate patient cost estimates based on CPT codes and insurance coverage - Verify copays, deductibles, and out-of-pocket expenses - Assist with patient billing inquiries and insurance-related questions - Medical Records & Clinical Documentation Coordination (Top Priority) - Process and follow up on medical record requests - Ensure imaging reports, laboratory results, and medical records are received before appointments - Review clinical notes and extract relevant information for authorizations - Maintain accurate documentation within the EHR/EMR system - Monitor internal communications and respond to authorization-related requests in real time - Additional Administrative Support - Follow up on billing claims and insurance issues - Manage documentation related to referrals, insurance, billing, and patient records - Provide administrative support for healthcare operations and scheduling workflows Software & Systems - CGM EMD (CompuGroup Medical EMD) - Microsoft Teams - SIP Trunk VoIP System - Sangoma Digium App Key Performance Indicators (KPIs) - Timely submission and approval of prior authorizations - Accurate insurance verification and patient cost estimates - Efficient management of referrals and authorization requests - Complete and accurate documentation within the EHR - Timely follow-up on insurance and medical record requests - Responsiveness to urgent authorization and scheduling needs - Consistent communication with providers, nurses, insurance companies, and patients Qualifications - Extensive experience with prior authorizations is required - Extensive experience with insurance verification and benefits verification is required - Experience managing HMO referrals and authorization workflows is required - Strong understanding of CPT codes and medical billing processes is required - Experience working with U.S. healthcare practices is required - Healthcare administrative experience is required - Experience with vascular surgery, specialty care, or radiology authorizations is highly preferred - Previous virtual assistant experience preferred but not required Required Skills - Strong understanding of prior authorization processes - Experience handling radiology authorizations (CT, MRI, MRA, CTA, Ultrasound) - Ability to review clinical notes and gather supporting documentation - Experience with patient estimates and insurance benefit verification - Strong documentation and record management skills - Proficiency with EHR/EMR systems - Strong critical thinking and problem-solving abilities - Excellent organizational and time management skills - Ability to manage multiple authorization requests simultaneously - Strong communication skills with insurance companies, providers, nurses, and patients - Ability to work independently with minimal supervision - Strong sense of urgency and follow-through Preferred Qualities - Highly detail-oriented and accurate - Proactive and resourceful - Professional and dependable - Comfortable in a fast-paced healthcare environment - Quick learner who can adapt to new systems and workflows - Takes ownership of tasks and follows through to resolution Deal Breakers - No prior authorization experience - No insurance verification experience - No experience with HMO referrals - Weak understanding of CPT codes and medical billing processes - No experience working with U.S. healthcare practices - Poor attention to detail - Inability to manage multiple requests simultaneously - Lack of responsiveness during work hours - Failure to comply with HIPAA, security, antivirus, or VPN requirements Basic Requirements - Must be proficient in speaking and writing English very clearly - Must have relevant work experience - Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory] - Must be available for video meetings with your camera on (when needed) Technical Requirements - Device: Reliable laptop or desktop computer. - Internet: High-speed connection (minimum 25 Mbps). - Audio: Noise-canceling headset. - Video: Webcam for virtual meetings. - Workspace: Quiet, professional environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.