I have been working in the field of Utilization Review and Substance Use Disorders for many years. I have been director of UR for multiple companies. In my capacity as UR director, I have performed quality assurance reviews, staff training, and development directed to the type of charting required by insurance carriers.
To aid in the UR process, I have also worked with staff to upgrading clinical documentation. Each specialty requires a specific type of clinical documentation and UR is no different. The key is to ensure that patients get the treatment they need to obtain recovery while simplifying the documentation process for staff. This overall approach improves the odds of getting a greater number of days certified at higher levels of care. It also improves odds of winning Peer-Peer Review, Expedited Appeals, and all levels of written appeal, and even to win law suits when companies do not pay.
I have trained some of the best UR Staff anywhere, as such can also provide back up of individuals with knowledge and experience. If you are looking for a solution to your UR issues. I believe I can help. I have an established record of accomplishment and extensive experience of dealing with all mayor carriers.
Outsourcing your UR will save money in comparison to having in house employees. Also, most people that UR are individuals that fell into the position because they had some clinical background but no true training in UR. You would not go to a doctor to do Surgery whose specialty is Internal Medicine. UR is a specialty. I believe you will find that my services will pay for themselves in the additional recovery of revenue for the companies you represent and in turn from proceeds received from billing.
Attached please find my Curriculum Vitae. I am looking for employment in a setting consistent with my life experience and educational background.In the hope that you may soon need abilities of this kind or may know of others who do, I would appreciate the opportunity to discuss how we can work together.
Relevant Professional Strengths
● Diagnostic evaluations / assessments
● Bio-psychosocial Assessments
● One-on one / group counseling
● Intervention planning / execution
● Regulatory / statutory compliance
● Crisis intervention / management
● Discharge planning and follow up
● Work collaboratively with family member’s
INDEPENDENT CONTRACTOR/ PEERS, EXPEDITED APPEALS, ALL LEVELS OF WRITTEN APPEALS
Kool Living Recovery Center:
UR PHYSICIAN SUBSTANCE ABUSE COUNSELING, MEDICAL ADMINISTRATION, CONSULTATION & QUALITY ASSURANCE
SERVICES, Plantation, FL 2004- 2010
INTERNATIONAL MEDICAL CONSULTANTS, Gainesville, FL 1997 to 2004
Bachelor of Arts, Queens College CUNY, Queens, N.Y.
Sociology Major with a Minor in Special Physical Education,
Clinical Teaching Appointment, Columbia University College of Physicians & Surgeons, New York, NY
Affiliate Professor, New York School of Medicine, department of Psychiatry, Valhalla, NY
Assistant Professor, Miami School of Medicine, department of Psychiatry, Miami, FL
Certified in Forensic Psychiatry, South FL Evaluation & Treatment Center, Miami, FL
Board Certification from the American Academy of Pain Management
HIPPAA (Health Insurance Portability Accountability Act 1996) Basic Training
Substance Abuse Resident, Beth Israel Hospital, New York, NY
Addiction Medicine Training CME Credits from FMA & FMPG
Psychotherapy Training at Cornel & Columbia Dept. of Psychiatry
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