Interim Director of Utilization Review and Denials

Our INTERIM DIRECTOR OF UTILIZATION rEVIEW AND DENIALS possesses the following attributes:

  • Over 10 years in Case Management and Utilization Management
  • RN, BSN
  • Educated physicians and staff on medical necessity to decrease denied claims
  • Managed over 20 FTEs
  • Expert with InterQual and MCG Guidelines, Medicaid/care and dual health plans
  • One-on-one staff audits, training and mentoring
  • Created system for denial/appeals staff to use a database of template appeal letters that support medical necessity, LOC and payer requirements
To discuss this or any of our other candidates, please contact Marty Fitzgerald.