
Contact this Consultant
- Company: AMERICLIN CONSULTING
- Phone: (843) 949-0927
- Cell: (843) 949-0927
- Fax: 843-837-7778
Profession: Physician (MD or DO) and Pharmacology
Current ABMS or AOA Board Specialty and Subspecialty Certification(s): Internal Medicine
Licenses: Kentucky, North Carolina, Pennsylvania, and Virginia
Additional Information: Experienced senior physician executive in the health insurance industry. Yale-educated, NIH-trained. Certified as Health Insurance Executive. National insurance companies worked for include Blue Cross & Blue Shield, Wellpoint, Anthem, and Cigna. Conducted over 2,000 committee and in-person patient grievance & appeal reviews. Conducted over 5,000 utilization/medical necessity reviews. Conducted over 500 physician appeal hearings; and 100 physician coding audits. Served as an examiner for the Malcolm Baldrige National Quality Award and the National Committee for Quality Assurance.
Education: MD-Yale University School of Medicine, MBA-Virginia Commonwealth University, and BSC, Pharmacy-Howard University College of Pharmacy
Years in Practice: 16+ years
Number of file reviews previously performed: 100+ file reviews
Average monthly hours in direct patient care: Not currently practicing