Physician Advisor and Clinical Denial - Guadalajara, Mexico

MissionHires; Región Centro; Vor Ort; MXN 558.000 - 781.200; Vollzeit

Zusammenfassung

Gracemark is looking for a Physician Advisor and Clinical Denial Specialist in Guadalajara, MX. This onsite role involves ensuring accurate medical documentation, managing denials and appeals, and facilitating communication between teams and insurance providers.

The successful candidate will have an MD degree, strong ethics, and at least one year of experience in medical records. If you're passionate about making a positive impact in healthcare, we encourage you to apply.

Qualifikationen

• 1+ years of experience in medical records and denials.
• Strong ethics and time management skills.
• Ability to work both independently and as part of a team.

Aufgaben

• Evaluate medical necessity and compliance of admissions.
• Conduct admission reviews and case management.
• Support claims, reimbursement, denials, and appeals processes.

Kenntnisse

Medical necessity evaluation

Claims management

Fluent English

Attention to detail

Independent work

Ausbildung

Doctor of Medicine (MD) degree

Jobbeschreibung

Gracemark is seeking a dedicated Physician Advisor and Clinical Denial Specialist to join our team in Guadalajara, MX. In this onsite role, you will play a critical part in supporting our healthcare operations by ensuring the accuracy and compliance of medical documentation, managing denials and appeals, and facilitating communication between clinical teams and insurance providers. If you are passionate about integrity, excellence in service, and making a positive impact in healthcare, we invite you to apply and grow with us.

Responsibilities

• Evaluate medical necessity and compliance of admissions and services
• Conduct admission reviews and case management
• Support claims, reimbursement, denials, and appeals processes
• Liaise with physicians and insurance providers to ensure accurate documentation
• Ensure completeness of clinical documentation
• Facilitate communication between interdisciplinary teams
• Participate in utilization reviews and quality improvement initiatives

Requirements

• Doctor of Medicine (MD) degree
• Minimum 1 year of experience in medical records and denials
• Fluent written and spoken English
• Strong ethics, attention to detail, and time management skills
• Ability to work independently and collaboratively
• Must reside in Guadalajara, MX
• Onsite position (no remote work)