Clinical Review Specialist
hace 15 horas
We are seeking a highly skilled Clinical Review Specialist to join our team at IBI Healthcare Institute. As a Clinical Review Specialist, you will play a critical role in ensuring that preauthorization requests for medical procedures are thoroughly evaluated and processed in a timely manner.
Key Responsibilities:- Review and evaluate preauthorization requests for medical procedures to ensure compliance with established medical guidelines and protocols.
- Collaborate with healthcare providers, physicians, and other stakeholders to obtain additional information or clarification as needed.
- Conduct benefit reviews to determine insurance coverage for proposed medical procedures.
- Communicate with insurance companies to obtain preauthorization approvals and address any denials or discrepancies.
- Maintain accurate and detailed records of preauthorization requests, approvals, and denials.
- Stay updated on changes in insurance policies, medical guidelines, and industry regulations affecting preauthorization processes.
- Provide guidance and education to healthcare providers and staff on preauthorization requirements and best practices.
- Work closely with billing and coding teams to ensure accurate and timely processing of preauthorized procedures.
- Participate in continuous quality improvement initiatives to enhance the efficiency and effectiveness of the preauthorization process.
- Clinical background, preferably with a degree in nursing or a related field.
- Proven experience in a preauthorization or utilization review role, specifically within a large surgical center.
- In-depth knowledge of medical procedures, terminology, and documentation requirements.
- Familiarity with insurance benefit reviews and the preauthorization process.
- Strong communication and interpersonal skills to effectively collaborate with healthcare providers, insurance companies, and internal teams.
- Detail-oriented with excellent organizational and time-management skills.
- Ability to work independently and make informed decisions in a fast-paced environment.
- Proficient computer skills, including experience with electronic health records (EHR) and preauthorization software.
- Knowledge of relevant healthcare regulations and compliance standards.
Our mission is to provide high-quality, accessible, and affordable surgical care solutions. We are a surgical group devoted to providing the highest quality healthcare services. Our vision is to become the most respected and successful surgical group in the United States for our patients, members, and partners.
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Clinical Monitoring Specialist
hace 3 días
San Cristóbal de las Casas, Chiapas, México Thermo Fisher Scientific A tiempo completoJob SummaryWe are seeking a highly skilled Clinical Monitoring Specialist to join our team at Thermo Fisher Scientific. As a key member of our clinical operations team, you will be responsible for ensuring the integrity and quality of our clinical trials.Key ResponsibilitiesMonitor investigator sites with a risk-based approach, applying root cause analysis...
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Clinical Rater Specialist
hace 12 horas
San Cristóbal de las Casas, Chiapas, México Signant Health A tiempo completoAbout the RoleAt Signant Health, we're revolutionizing the clinical trial landscape with innovative technology and services. As a Clinical Rater, you'll play a critical role in delivering high-quality data and driving business success.Key ResponsibilitiesProvide data oversight for Signant Health Rater Training, Endpoint Reliability, and Quality Assurance...
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Clinical Trial Manager
hace 14 horas
San Cristóbal de las Casas, Chiapas, México Iqvia A tiempo completoJob Title: Clinical Trial Manager - OncologyAt IQVIA Biotech, we are committed to supporting small biotech and biopharma companies in their clinical trials. We are seeking an experienced Clinical Trial Manager to join our team.Key Responsibilities:Develop and implement clinical monitoring plans to ensure the successful execution of clinical...
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Clinical Trials Manager
hace 12 horas
San Cristóbal de las Casas, Chiapas, México Iqvia A tiempo completoJob SummaryWe are seeking a highly experienced Clinical Trials Manager to join our team at IQVIA Biotech. As a key member of our clinical monitoring team, you will be responsible for the successful planning, implementation, and execution of contracted clinical monitoring activities.Key ResponsibilitiesManage clinical trials in LATAM and North America, with a...
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Study Start-Up Specialist II
hace 15 horas
San Cristóbal de las Casas, Chiapas, México Iqvia A tiempo completo**Job Summary**We are seeking a highly skilled Study Start-Up Specialist II to join our team at IQVIA. As a key member of our start-up team, you will be responsible for ensuring the quality and regulatory compliance of Principal Investigator (PI) credentials, Essential Documents (ED), and Investigator Site Files (ISF) during the start-up process.**Key...
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Regulatory Services Specialist
hace 12 horas
San Cristóbal de las Casas, Chiapas, México Iqvia A tiempo completoRegulatory Services Imports SpecialistThe Country Site Activation team is dedicated to identifying and activating sites to the highest quality, ensuring patients on clinical trials have access to safe and effective medication. As a Regulatory Services Imports Specialist, you will perform tasks at a country level associated with Study Start Up contracts,...
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Senior Clinical Research Associate
hace 3 días
San Cristóbal de las Casas, Chiapas, México Icon A tiempo completoSenior Clinical Research AssociateAt ICON, we're driven by a shared vision to advance and improve patients' lives. Our diverse teams enable us to become a better partner to our customers and help us deliver excellence to our clients and patients at every touch-point.Job SummaryWe're seeking a highly motivated and experienced Senior Clinical Research...
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Regulatory and Site Activation Manager
hace 15 horas
San Cristóbal de las Casas, Chiapas, México Iqvia A tiempo completoJob OverviewAs a Regulatory and Site Activation Manager at IQVIA, you will be responsible for directing and managing the delivery of site activation, maintenance, and regulatory activities for selected studies or multi-protocol programs. Your expertise will be crucial in overseeing the execution of site activation and maintenance, ensuring compliance with...
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Regulatory Affairs Specialist, LATAM
hace 3 días
San Cristóbal de las Casas, Chiapas, México Iqvia A tiempo completoRegulatory Affairs Specialist, LATAM**Job Summary**We are seeking a highly skilled Regulatory Affairs Specialist to join our team in LATAM. The successful candidate will be responsible for providing regulatory information, guidance, training, support, and strategic planning to assigned clinical research projects.**Key Responsibilities**Assist in assuming...
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Clinical Research Coordinator
hace 15 horas
San Cristóbal de las Casas, Chiapas, México Thermo Fisher Scientific A tiempo completoJob SummaryWe are seeking a highly organized and detail-oriented Patient Recruitment Associate I to join our team at Thermo Fisher Scientific. In this role, you will be responsible for screening potential volunteers for clinical studies, scheduling appointments, and conducting demographic and medical history interviews.Key ResponsibilitiesScreen potential...
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Country Regulatory Specialist
hace 3 días
San Cristóbal de las Casas, Chiapas, México Thermo Fisher Scientific A tiempo completoJob SummaryWe are seeking a highly skilled Country Approval Specialist to join our team at Thermo Fisher Scientific. As a key member of our global submission team, you will play a critical role in ensuring the successful approval of our clinical trials in various countries.Key ResponsibilitiesPrepare and review local EC submissions in alignment with our...
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Import Logistics Specialist
hace 13 horas
San Cristóbal de las Casas, Chiapas, México Gorilla Paper Inc A tiempo completoJob Summary: We are seeking a highly skilled Import Logistics Specialist to join our team at Gorilla Paper Inc. As an Import Logistics Specialist, you will be responsible for maintaining job and inventory item costing, invoicing, and reconciliations for our hospitality division.Key Responsibilities:Review agreements and purchase orders for business terms and...
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Medical Billing Specialist
hace 3 días
San Cristóbal de las Casas, Chiapas, México Hr Staffing Llc A tiempo completoMedical Billing Specialist OpportunityAbout the Role:Hr Staffing, LLC is seeking a skilled Medical Billing Specialist to join our team. As a Medical Biller, you will be responsible for reviewing and submitting insurance claims, collecting payments from insurance and patients, and researching and resolving outstanding claims and patient balances.Key...
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Recruitment Specialist
hace 16 horas
San Cristóbal de las Casas, Chiapas, México Computer Consultants International, Inc. A tiempo completo**Job Summary**We are seeking a highly skilled Recruitment Specialist to join our team at Computer Consultants International, Inc. as an It Recruiter. The ideal candidate will have a minimum of 2+ years of experience in recruitment, with a proven track record of success in high-volume recruiting environments.Key Responsibilities:Review and understand...
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Trade Finance Specialist
hace 15 horas
San Cristóbal de las Casas, Chiapas, México America Steel Trade Corporation A tiempo completoAmerica Steel Trade Corporation, a leading international trading company, is seeking a skilled Trade Finance Specialist to facilitate international trade transactions. The ideal candidate will possess a deep understanding of global trade practices, financial instruments, and compliance regulations.Key Responsibilities:Review financial statements of customers...
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Pharmacovigilance Specialist Argus
hace 15 horas
San Cristóbal de las Casas, Chiapas, México Iqvia A tiempo completoJob SummaryWe are seeking a highly skilled Pharmacovigilance Specialist to join our team at Iqvia. As a key member of our Safety team, you will be responsible for ensuring the quality and integrity of safety data, while providing exceptional support to our clients.Key ResponsibilitiesProcess safety data in accordance with applicable regulations, guidelines,...
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Senior Customer Success Specialist
hace 3 días
San Cristóbal de las Casas, Chiapas, México Integer A tiempo completoCustomer Success SpecialistAt Integer, we're committed to delivering exceptional customer experiences that drive long-term success. As a Customer Success Specialist, you'll play a critical role in ensuring our customers receive the best possible service.Key Responsibilities:Adhere to Integer's values and safety, environmental, security, and quality...
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Trial Contracts Specialist
hace 17 horas
San Cristóbal de las Casas, Chiapas, México Thermo Fisher Scientific A tiempo completoJob SummaryWe are seeking a highly skilled Contract Negotiation Specialist to join our team at Thermo Fisher Scientific. As a key member of our global team, you will be responsible for preparing, reviewing, and finalizing global investigator grant budget and payment schedule terms and conditions templates for multiple studies.Key ResponsibilitiesDevelop and...
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Corporate Invoicing Specialist
hace 12 horas
San Cristóbal de las Casas, Chiapas, México Profitcoach A tiempo completo**About Us**ProfitCoach is a leading provider of property management accounting and advisory services, guided by core Christian values that foster a culture of excellence and growth. Our team thrives in a remote work environment, prioritizing productivity, coaching, and professional development.**Our Ideal Candidate**We seek highly motivated and...
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Cybersecurity Specialist
hace 2 días
San Cristóbal de las Casas, Chiapas, México Nefter A tiempo completoJob SummaryNefter is seeking a highly skilled Cybersecurity Specialist to join our Red Team within our security practice. As a member of our security services consulting team, you will work in a collaborative environment to assist clients in the evaluation and remediation of security risks.Key ResponsibilitiesPerform Red Team, Penetration Testing, and Social...