Medical consultant
NEURON LLC
Total years of experience :8 years, 1 Months
Monitors quality of the department workflow and audits the medical justification of approvals.
❖ Responds to agents medical queries
❖ Drafts high cost cases and assists supervisors for complicated medical cases
❖ Works with Quality Lead in delivering departmental projects
❖ Working with assistant companies facilitating international OTN provider coverage.
❖ Arranging second medical opinion for needed cases
❖ Develops new medical guidelines that can serve as team reference Arranging second medical opinion
for needed cases
❖ Direct communication with Neuron clients answering queries and drafting cases to obtain payers’
approvals
❖ Keeping TAT replying to all cases received
❖ Attending professionally to all e-mails and telephone calls coming from members, brokers, clients and
other departments
❖ Cost containment and screening for fraud and abuse
❖ Underwriting and initial assessment.