Renata Vieira Ferreira
Port Coquitlam,BC
Summary
Healthcare professional with a decade of experience enhancing accuracy in medical documentation and compliance. Expertise in adjudicating complex claims and conducting quality reviews to ensure adherence to regulatory standards. Eager to transition this commitment to quality and operational excellence into Regulatory Publishing and Operations in the pharmaceutical sector.
Overview
3
3
Languages
17
17
years of professional experience
Work History
Group Benefit Examiner
Canada Life
04.2022 - Current
- Review and adjudicate complex medical and dental claims while ensuring compliance with policy requirements and regulatory guidelines.
- Analyzed medical documentation for completeness, consistency, and accuracy to support timely claim determinations.
- Performed detailed quality reviews to ensure accurate claim processing and compliance with internal standards, enhancing overall claim integrity.
- Collaborated with healthcare providers and internal stakeholders to obtain supporting documentation, resolving discrepancies and facilitating efficient claim resolutions.
- Prepare professional written communications regarding claim decisions and documentation requirements.
- Maintain electronic claim documentation and ensure accurate record management.
- Consistently achieve productivity and quality performance targets while managing a high-volume workload.
Group Benefit Examiner
Randstad (Contract)
10.2021 - 03.2022
- Processed healthcare claims, ensuring accuracy and compliance for timely completion.
- Maintained electronic records and facilitated quality assurance activities.
- Reviewed policy documentation for accuracy and completeness before approval.
- Conducted thorough investigations on claims to determine validity and eligibility.
Advanced Recovery Specialist
Insurance Corporation of British Columbia (ICBC)
03.2021 - 08.2021
- Managed highly complex catastrophic claims involving extensive medical documentation.
- Reviewed healthcare records to determine benefit eligibility and regulatory compliance.
- Coordinated multiple stakeholders while maintaining complete and accurate electronic documentation.
- Managed documentation, approvals, and payment records with strong attention to accuracy and confidentiality.
- Developed detailed case documentation supporting regulatory and organizational requirements.
Administrative Assistant
Urban Active Sports Clinic
02.2020 - 08.2020
- Managed confidential patient records while ensuring documentation accuracy.
- Coordinated scheduling, billing, and administrative documentation.
- Processed insurance documentation and electronic claims submissions.
- Maintained electronic medical records using ClinicMaster EMR.
Health Claims Analyst & Medical Consultant
CONAMED – Medical Consulting and Audit
01.2010 - 08.2019
- Reviewed medical documentation to support accurate healthcare coverage decisions, ensuring adherence to guidelines.
- Evaluated clinical records for completeness, accuracy, and regulatory compliance.
- Conducted medical audits to verify documentation quality and adherence to established standards.
- Identified documentation discrepancies and ensured corrective actions prior to claim approval.
- Collaborated with healthcare providers to clarify documentation requirements, facilitating timely case resolution.
- Prepared detailed technical reports summarizing medical findings and recommendations.
- Maintained comprehensive electronic records, safeguarding confidentiality and ensuring compliance with regulatory standards.
Coordinator, Public Health
State Health Department of Bahia (SESAB), Brazil
08.2011 - 12.2018
- Coordinated healthcare programs in highly regulated public health environment to ensure compliance and effective service delivery.
- Coordinated multidisciplinary teams across hospitals, emergency services, and outpatient facilities.
- Reviewed and evaluated clinical documentation to support informed healthcare decisions and enhance patient outcomes.
- Maintained electronic health information while ensuring compliance with government healthcare regulations.
- Prepared reports and maintained regulatory documentation to support healthcare operations and regulatory compliance.
Education
Introduction To Regulatory Affairs
University of British Columbia
Vancouver12-2023
Master of Administrative Sciences - Global Health and Human Services
Fairleigh Dickinson University
Vancouver, BCVancouver, BC
Doctor of Medicine (M.D.) -
Federal University of Bahia
BrazilBrazil
Certificate in Occupational Medicine -
Estácio de Sá University
BrazilBrazil
Disability Management Studies -
Pacific Coast University
British Columbia, CABritish Columbia, CA
Skills
- Medical and Dental Claims Adjudication
- Regulatory Compliance
- Healthcare Regulatory Operations
- Medical Documentation Review
- Document Review and Validation
- Regulatory Documentation
- Electronic Medical Records (EMR)
- ClinicMaster
- Document management systems
- Data Entry
- Microsoft Office Suite
- Time and Project Management
- Cross-functional Collaboration
- Stakeholder Communication
- Quality and compliance commitment
- Attention to Detail
- Team collaboration
- Written and verbal communication
- Quality and compliance commitment
Languages
English
Full Professional
Portuguese
Native/ Bilingual
Spanish
Limited
Timeline
Group Benefit Examiner
Canada Life
04.2022 - Current
Group Benefit Examiner
Randstad (Contract)
10.2021 - 03.2022
Advanced Recovery Specialist
Insurance Corporation of British Columbia (ICBC)
03.2021 - 08.2021
Administrative Assistant
Urban Active Sports Clinic
02.2020 - 08.2020
Coordinator, Public Health
State Health Department of Bahia (SESAB), Brazil
08.2011 - 12.2018
Health Claims Analyst & Medical Consultant
CONAMED – Medical Consulting and Audit
01.2010 - 08.2019
Introduction To Regulatory Affairs
University of British Columbia
Master of Administrative Sciences - Global Health and Human Services
Fairleigh Dickinson University
Doctor of Medicine (M.D.) -
Federal University of Bahia
Certificate in Occupational Medicine -
Estácio de Sá University
Disability Management Studies -
Pacific Coast University