Profession: Physician (MD or DO)

Current ABMS or AOA Board Specialty and Subspecialty Certification(s): Addiction Medicine, Internal Medicine, and Occupational Medicine

License: California

Additional Information: *Perform second level appeals for Independent Review Organizations according to URAC/NCQA standards such as medical necessity determinations, healthcare authorizations and denials. *Perform chart reviews for beneficiaries of commercial health plans to determine medical necessity and length of stay. *Perform health care authorization and denials for diagnostic tests and treatment.

Education: MD-University of Nigeria, Nigeria, Diplomate, American Board of Internal Medicine-American Board of Internal Medicine, Certified Correctional Healthcare Physician (CCHP-P)-National Commission on Correctional Healthcare, and Qualifed Medical Examiner (QME)-California Department of worker's Compensation.

Years in Practice: 6 to 15 years

Number of file reviews previously performed: 100+ file reviews

Average monthly hours in direct patient care: 80+ hours