Physician Advisor and Clinical Denial - Guadalajara, Mexico

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
• P...