Job Title: Medical Review Physician About the Role: We are seeking a dedicated physician to join our utilization review team. In this pivotal role, you will be the key medical authority ensuring that patient care is medically necessary, appropriately documented, and aligns with reimbursement policies. Your Key Responsibilities: Conduct comprehensive reviews for patient admissions, services, and length of stay, assessing for medical necessity against established criteria. Perform concurrent chart reviews to ensure clinical documentation supports the level of care provided. Act as a clinical liaison between treating physicians and health plans, facilitating discussions on patient care and documentation requirements. Analyze and appeal denials from insurance payers by writing robust letters and compiling supporting evidence from medical records. Identify gaps in clinical documentation and consult directly with attending physicians to ensure completeness and accuracy. Meticulously document all actions and outcomes in the electronic record system. Participate in peer review meetings and contribute to projects aimed at improving care quality and efficiency. You Will Thrive If: You possess a valid Mexican medical license (Cédula Profesional de Médico Cirujano). You have advanced English proficiency (both written and spoken) for reviewing complex charts and communicating with international stakeholders. You have a strong analytical mind, impeccable integrity, and attention to detail. What We Offer:A stable schedule with consistent hours. Comprehensive training for those without prior experience in medical review or denial management.A professional environment that values your expertise.