• Perform comprehensive charge audits for inpatient and outpatient services. • Review itemized billing statements against medical records to verify accuracy and completeness. • Identify and document: • Missing charges • Duplicate charges • Unsupported or non-compliant charges • Validate charges based on clinical documentation, coding rules, and billing guidelines. • Ensure all billing aligns with: • CMS and payer requirements • National healthcare billing audit guidelines • Organizational compliance standards • Submit clear, actionable audit findings to revenue cycle teams for correction and rebilling. • Analyze audit findings to determine root causes and patterns. • Maintain accurate audit documentation that is clear, traceable, and defensible. • Track audit outcomes and financial impact. • Assist in developing recommendations to improve charge capture accuracy and billing processes. • Partner with: • Coding and billing teams • Clinical departments • Revenue cycle leadership • Provide guidance on: • Documentation requirements • Charge capture practices • Billing compliance standards • Support education efforts to prevent recurring audit issues.

• Prospective auditing of exams, procedures, medications, etc.; • Perform preliminary review of medium- and high-complexity authorization forms, issuing a favorable or unfavorable opinion according to scope of competence; • Route authorization forms as needed to the appropriate specialty; • Communicate in writing to the person responsible your observations, recommendations, and conclusions from the preliminary audit.

• Retrospective Medical Claims Audit: Perform technical analysis and auditing of medical-hospital accounts, ensuring compliance between the care provided, billed items, medical protocols and contracted agreements. • Regulatory Management and ANS: Prepare medical opinions and technical responses to Preliminary Intermediation Notifications (NIP) and correspondence directed to the National Supplementary Health Agency (ANS). • Defenses and Appeals: Prepare technical responses and defenses to Notices of Infraction addressed to the ANS, working in coordination with the legal and regulatory departments. • Continuous Improvement: Identify clinical/operational deviations and propose corrective measures to ensure faithful compliance with established standards for the provision of medical care in the supplementary health sector.

• Perform technical analyses of FTTH/FTTx networks, evaluating backbone, access, cabling, CTOs (optical termination boxes), CEOs (optical splice closures), routes and other passive network elements; • Evaluate designs, inventories, technical documentation and as-built records, identifying inconsistencies, operational risks and opportunities for improvement; • Analyze network engineering criteria, including splitting architecture, asset occupancy, capacity saturation and design risks; • Audit the quality and reliability of georeferenced network documentation (GIS, KMZ/KML and inventory systems); • Work with tools and systems used by ISPs, validating consistency between documentation, records and existing infrastructure; • Evaluate signal indicators and CPE telemetry, correlating performance data with potential causes in the passive network; • Consolidate operational and technical data, turning information into KPIs, executive reports and strategic recommendations; • Classify risks and opportunities considering operational, financial impact and business continuity; • Support the preparation of audit and due diligence reports to support decision-making in provider acquisition processes.