About Sharon McLaughlin-Weber
I am an advocate for clean living. There is no need for harmful chemicals in the products that we use or the food that we eat. Learn more at Going Green MD. Medical Director Experience. I am certified in both coding and medical auditing. My experience includes, Evaluation of authorization requests in a timely manner, provided support for nurse reviewers and managed the denial process. I have conducted concurrent and retrospective reviews of claims and appeals and resolved grievances related to medical quality of care. I have ensured that the medical care provided meets the standards for acceptable medical care. I have fostered clinical practice guideline implementation and evidenced-based medical practice. I have participated in professional and community activities that have provided input and became knowledgeable regarding regulatory, professional and community standards and issues. I have the ability to maintain attendance to support required quality and quantity of work with the ability to work remotely. In the 4 1/2 years with my current company I have yet to call in sick. I have maintained confidentiality and complied with Health Insurance Portability and Accountability Act (HIPAA). I have performed claim review for all lines of businesses. I have performed claim review for all products and services. I have lead a cost saving project. I have worked with the Special Investigations Unit performing reviews and interviews. I have participated in policy creation. Striving for excellence is important to me. I like to think outside the box and help develop policies and procedures that can help institute efficiency and reduce costs. I enjoy developing new products in this ever-changing health care system.If you think I can be of value to your team, please reach out to me.
