• Realizar auditoria retrospectiva de contas hospitalares e ambulatoriais de forma 100% remota; • Analisar prontuários, faturamentos e despesas médicas utilizando o sistema Facplan; • Avaliar a pertinência técnica das cobranças de materiais, medicamentos, diárias e taxas; • Elaborar relatórios analíticos e pareceres técnicos referentes às auditorias retrospectivas concluídas; • Atuar na análise de recursos de glosas (quando aplicável ao fluxo retrospectivo).

• Perform centre audit/monitoring activities with new and existing centres to ensure compliance with LanguageCert’s centre approval criteria and associated policies and procedures • Provide centres with clear and constructive advice, support and guidance with regard to internal quality arrangements and LanguageCert’s qualifications, policies and procedures and regulatory requirements • Carry out announced and/or unannounced visits to monitor the conduct and integrity of examinations • Carry out audit activities to verify the compliance of a new examination room/venue according to LanguageCert’s set specifications • Complete accurate centre audit reports/records, written in a clear and constructive manner, returning them to LanguageCert and the centre no later than 5 business days after the audit activity • Inform centres of any identified non-compliance and actions required to remedy • Monitor and follow-up on identified centre non-compliance to ensure appropriate close out of actions required • Recommend to the Quality Officer sanctions to be imposed on centres • Undertake investigations regarding alleged malpractice / maladministration as assigned by the Quality Officer • Demonstrate full understanding and implementation of LanguageCert’s systems, process, policies and procedures to ensure compliance with internal Management Systems • Provide any audit clarifications required • Attend training/standardisation events from time-to-time throughout each calendar year • Declare any existing or prior activities which would/may conflict with the role of QA and report, in writing, any conflicts that may, from time-to-time occur • Act as a goodwill ambassador for LanguageCert by the courteous treatment of all customers, ensuring at all times that the professionalism of the company is upheld • Maintain own Health & Safety and that of LanguageCert staff and candidates in accordance with the company’s Health & Safety requirements.

Role Description PeopleCert, on behalf of LanguageCert, is seeking Quality Auditors (QAs) on a project basis to ensure that approved centres comply with LanguageCert and regulatory requirements. This role involves conducting external quality assurance audits to assess a centre’s infrastructure, systems, and internal quality assurance arrangements. The QA will verify that processes and practices are effectively implemented and aligned with LanguageCert’s standards. - Perform centre audit/monitoring activities with new and existing centres to ensure compliance with LanguageCert’s centre approval criteria and associated policies and procedures. - Provide centres with clear and constructive advice, support and guidance with regard to internal quality arrangements and LanguageCert’s qualifications, policies and procedures and regulatory requirements. - Carry out announced and/or unannounced visits to monitor the conduct and integrity of examinations. - Carry out audit activities to verify the compliance of a new examination room/venue according to LanguageCert’s set specifications. - Complete accurate centre audit reports/records, written in a clear and constructive manner, returning them to LanguageCert and the centre no later than 5 business days after the audit activity. - Inform centres of any identified non-compliance and actions required to remedy. - Monitor and follow-up on identified centre non-compliance to ensure appropriate close out of actions required. - Recommend to the Quality Officer sanctions to be imposed on centres. - Undertake investigations regarding alleged malpractice/maladministration as assigned by the Quality Officer. - Demonstrate full understanding and implementation of LanguageCert’s systems, process, policies and procedures to ensure compliance with internal Management Systems. - Provide any audit clarifications required. - Attend training/standardisation events from time-to-time throughout each calendar year. - Declare any existing or prior activities which would/may conflict with the role of QA and report, in writing, any conflicts that may, from time-to-time occur. - Act as a goodwill ambassador for LanguageCert by the courteous treatment of all customers, ensuring at all times that the professionalism of the company is upheld. - Maintain own Health & Safety and that of LanguageCert staff and candidates in accordance with the company’s Health & Safety requirements. Qualifications - Exceptional command of the English language (native-like fluency or C2 level certification preferred). Certifications such as LanguageCert C2 LTE or C2 IESOL are a plus. - Relevant quality assurance experience in the context of training and/or examination. - Familiarity with equal opportunities and anti-discriminatory practices. - Availability on demand, at short notice from time-to-time; frequent travelling may be required. - Efficient completion of administrative duties, including completion of reports in a timely manner. - Representation of LanguageCert in a firm, but professional and polite manner. - Ability to communicate and nurture and develop effective professional working relationships. - Ability to meet deadlines and keep to schedules. - Punctuality and reliability, maintaining high levels of integrity at all times. - Exceptional attention to detail. Benefits - Competitive remuneration package 💲 - Work in an international, dynamic and fun atmosphere 💯 - Huge learning experience in using best practices and global environment 📈 - Constant personal and professional development 🥇 Company Description PeopleCert is a global leader in assessment and certification of professional skills, partnering with multi-national organizations and government bodies for the development & delivery of standardized exams. Delivering exams across 200 countries and in 25 languages over its state-of-the-art assessment technology, PeopleCert enables professionals to boost their careers and realize their life ambitions. - Quality, Innovation, Passion, Integrity, Clarity, and Velocity are the core values which guide everything we do. - Our offices in UK, Greece, Cyprus, and India boast a culture of diversity, where everyone is different, yet everyone fits in. - All of us at PeopleCert are committed to the reflection of the diversity and inclusion of our customers and the communities in which we do business.

Title: Elite Premium Insurance Field Auditor Job Identification14837 Job RoleTotal Quality Management -Premium Audit Experience (In Years)0-3 Job Location Baltimore, MD Job Description: About the EXL Insurance Premium Audit Group: A leader in the field, EXL can complete all levels of premium audits on all auditable exposure types. We train our 450+ highly skilled professionals worldwide utilizing our industry-leading training platform and curriculum. This expertise is combined with a technology-enabled proprietary platform, with predictive modeling capabilities. Using a Premium Audit selection model, the team can predict the likelihood of policy misclassification, automatically assign audit methods to save carriers time and money, and use machine learning to continuously improve correlation and prediction accuracy. Why work for the EXL Insurance Premium Audit Team? - 17 days paid vacation, plus 10 paid holidays - Work from home when not in the field - Competitive base compensation, including performance-based bonuses. - Benefits package that includes medical, dental, vision, disability coverage, and 401k - Career advancement opportunities - Laptop and other necessary office equipment provided ***Applicants must have 5+ years’ experience performing remote/field Premium Insurance Audits to be considered for this Elite Premium Auditor role*** Job Description Summary: Advanced level position in which the incumbent’s responsibilities include performing physical and remote audits of insured’s business. Interviews, investigates, collects, and records information to be used in a written report that is provided to the insurance carrier. Compensation: - Pay Type: Hourly plus production bonus incentives, in accordance with EXL’s policies - Total compensation for this position, which is a combination of an hourly base rate plus production bonus incentives, is targeted between $60k - $90plus in total earnings within the first year.: - Hourly base rate is dependent upon job specific experience and location. There is no cap on production bonus incentives The posted range is the hiring range for this role — a subset of the broader range available to employees over time — and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process. Responsibilities Essential Duties and Responsibilities: - Performs audit activities as assigned by the Area and/or Regional Manager. - Audit responsibilities will include determining audit priorities and scheduling to meet stated deadlines, preparation of appointment letters, performing detailed review of all related business records, and preparing written reports of findings. - Meets with business owners/managers to review audit results and implement any actions required. - Transmits completed reports to Quality Review for handling by the required due date. - Corrects and completes audits previously returned for correction and transmits back to Quality Review in a timely manner by Auditor expectations and SOP. Non-Essential Duties and Responsibilities: - Maintains accurate audit and business records related to, but not limited to, audit assignments, expense reports, time reporting, etc. - Performs other duties as assigned. Required Knowledge, Skills, and Abilities: - Strong analytical skills and an attention to detail. - Ability to manage time and perform responsibilities with little direct supervision. - Good interpersonal skills and ability to communicate effectively with co-workers and clients. - Ability to utilize resources available to complete assigned projects successfully. - Knowledge of computer applications to document and record audit findings. - Familiarity with the importance of audit functions. Qualifications - Ability to work independently from home - Experience with the MS Office Suite (excel, word, outlook, etc.) - Must be self-motivated, self-disciplined and exhibit a willingness to learn - Excellent time management - Excellent verbal and written communication skills - High School Diploma or GED required. Territory: Baltimore, MD and surrounding areas #RSREXL EEO/Minorities/Females/Vets/Disabilities Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL's total compensation package for employees. Other rewards may include bonuses, as well as a Paid Time Off policy, and many region specific benefits. Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy. Application & Interview Impersonation Warning – Purposely impersonating another individual when applying and / or participating in an interview in order to obtain employment with EXL Service Holdings, Inc. (the “Company”) for yourself or for the other individual is a crime. We have implemented measures to deter and to uncover such unlawful conduct. If the Company identifies such fraudulent conduct, it will result in, as applicable, the application being rejected, an offer (if made) being rescinded, or termination of employment as well as possible legal action against the impersonator(s). EXL may use artificial intelligence to create insights on how your candidate information matches the requirements of the job for which you applied. While AI may be used in the recruiting process, all final decisions in the recruiting and hiring process will be taken by the recruiting and hiring teams after considering a candidate’s full profile. As a candidate, you can choose to opt out of this artificial intelligence screening process. Your decision to opt out will not negatively impact your opportunity for employment with EXL.