Overview
intugo in partnership with a leading u.s.-based healthcare organization.
about the role: intugo is hiring to support a u.s. healthcare partner that specializes in medical review services for hospital admissions, case management, and insurance compliance across the united states. This is a unique opportunity to apply your medical expertise in a non-clinical, professional setting while deepening your knowledge of the u.s. healthcare system and insurance regulations.
what you'll do
as a bilingual doctor, you will play a key role in reviewing clinical cases and ensuring alignment with insurance and hospital policies. Your contributions will directly support decision-making and communication between healthcare providers and insurance carriers.
key responsibilities
* evaluate medical necessity of admissions and services (prospective, concurrent, retrospective)
* support discharge planning, utilization review, and case management
* serve as a liaison between attending physicians and physician advisors
* document denial cases and resolution efforts in the emr system
* manage all payor communications for appeals and system uploads
* collaborate on diagnosis, treatment plans, and clinical documentation
* participate in peer reviews and utilization management initiatives
department overview
this department focuses on the efficient review of medical services, supporting clinical teams in making informed decisions. The team plays a critical role in ensuring compliance with reimbursement policies and coordinating care within a structured, professional framework.
candidate profile
* strong english communication skills (spoken and written)
* minimum 6 months of clinical or hospital experience
* solid general medical knowledge
* excellent interpersonal and customer service skills
job details
* seniority level: entry level
* employment type: full-time
* job function: health care provider
* industries: business consulting and services
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