Contact

adf0p1@r.postjobfree.com

www.linkedin.com/in/medicallegal

(LinkedIn)

Top Skills

Pain Management

Workers Compensation

Managed Care

Languages

English (Native or Bilingual)

Korean (Native or Bilingual)

Spanish (Elementary)

Certifications

Functional Capacity Evaluation

Industrial Disability Evaluation

Lean Six Sigma - Yellow Belt

Cox Technique (Advanced Level)

Advanced Level Graston Technique

Tony Kim

Chiropractic Physician

Louisville, Kentucky Area

Summary

Skills:

Certified Chiropractic Insurance Consultant

Lean Six Sigma Yellow Belt

IME

FCE

Medical Chart Review

UR/Peer Review

Completed CSS prep course and ICD-10-CM program

ICD-9, ICD-10, CPT Coding

Clinic operation and management

Human anatomy, physiology, and pathology (http://lifewest.edu/ course-catalog/)

Workers Compensation

MTUS

ACOEM

ODG

AMA Impairment Guide

Treatment Authorization

Personal Injury

Cost Containment

Labor Code

Job Site Analysis

Injury Prevention

Qualified Medical Examiner

Healthcare marketing

Treatment of musculoskeletal injuries

Managing complex medical legal cases

Managed Care

Certified in Advanced Billing

Risk management

Wellness Care

Sports Nutrition

Clinic operation and management

Page 1 of 5

Experience

Once Upon A Child Clarksville/Sasung Inc

CEO/Owner

July 2016 - Present

Clarksville, In

Retail.

Overall P&L responsibility.

Marketing.

Managing staffs.

Operations.

Review Med

Physician Consultant - Independent Contractor

March 2015 - Present

Peer review and pre-authorization

MLS Group of Companies

Independent Consultant - Independent Contractor

March 2015 - Present

Peer reviews, IME

eviCore healthcare

Clinical Reviewer - Chiropractic

June 2017 - July 2019 (2 years 2 months)

Plainville, CT - Remote

The Chiropractic Clinical Reviewer is primarily responsible for performing utilization review of chiropractic services. Clinical Reviewer as a liaison to member doctors, their staff, and clients. Responsible for reviewing credentialing and re-credentialing files as needed, and may also serve on and/or report to eviCore’s Credentialing Committee. They are accountable identifying and support of QM special investigation unit of quality matters of high-risk or suspicious claims. Monitor practitioners for unusual and/or exceptional treatment patterns, and serve as an informational resource for Clinical Management and all other departments. May also be called upon to serve on or report to Quality committees. Also responsible for formulating clinical review criteria, and for creating or revising medical policy statements as necessary.

Page 2 of 5

Dane Street

Physician Advisor - Independent Contractor

May 2011 - November 2017 (6 years 7 months)

Utilization/Peer Review

Wellstone Regional Hospital/Zilmed

Chiropractic Physician

March 2016 - March 2017 (1 year 1 month)

Jeffersonville, In

Inpatient treatment

Functional assessment

Concentra

Physician Advisor - Independent Contractor

November 2014 - December 2016 (2 years 2 months)

Peer Reviews

California

State Panel QME

January 2009 - November 2014 (5 years 11 months)

Qualified Medical Evaluator for state of California's worker's compensation system.

The Spine and Orthopedic Center

Chiropractic Physician

June 2012 - July 2014 (2 years 2 months)

Initial workflow design and implementation of chiropractic program successfully integrating it with existing multidisciplinary occupational medicine group. Upon successful launch of the rehab department, effectively supervised it grossing over $3 million the first year and significant increased following years successively.

Lead clinician for non-surgical spine and orthopedic patients and post-op rehab cases.

Compliance consultant.

Treatment authorization specialist.

GLC

Executive Director of Bill Review (Temp Assignment) March 2012 - May 2012 (3 months)

Encino, CA

Page 3 of 5

Successful compliance audit led to recovery of 7 figure denied payment. Restructuring the billing strategy turned around pathology reimbursement going from 97% denial rate to 98% reimbursement rate while nearly doubling the fee schedule.

Designed and implemented workflow of the bill review department. Successfully trained staffs for initial launching of the bill review department. Supervised bill review department upon successful launching. Consultant for collection and litigation department on compliance. Consultant for clinics on coding compliance.

CR England

Company Physician

March 2011 - October 2011 (8 months)

Fontana, CA

DOT Physicals, Patient Education, Case Management, Functional Capacity Assessment, pre-employment/post-offer evaluation

Advanced Chiropractic Clinic

Clinic Director

September 2000 - November 2010 (10 years 3 months) Responsible for overall operation of the clinic.

Hired, supervised, and trained coders.

Business Development.

Qualified Medical Examination.

Independent Medical Examination.

Lead clinician.

Treatment of Musculoskeletal Injury.

Management of Complex Medical Legal Cases.

DOT/CDL Physical Examination.

Education

Life Chiropractic College West

Doctor of Chiropractic, Chiropractic · (1997 - 2000) California State Polytechnic University-Pomona

Chemistry/Premedicine · (1991 - 1994)

Palm Springs High School

Diploma, General Education · (1986 - 1990)

Page 4 of 5

Page 5 of 5

Contact this candidate