Troy Wohlgemuth
@troywohlgemuth
Senior medical documentation reviewer specializing in PIP claims, medical necessity, and injury progression.
What I'm looking for
I’m a licensed Doctor of Chiropractic and former Clinical Director with 25 years of experience evaluating musculoskeletal injuries tied to auto accidents, personal injury, and workers’ compensation. I review medical records, diagnostic imaging (X-ray, MRI, NCV studies), and clinical documentation to support insurance-related decisions.
In my work, I assess injury causation, symptom progression, and treatment necessity, ensuring documentation stays consistent and compliant with payer requirements over time. I also handle CPT and ICD-10 coding in billing processes and support utilization review and prior authorization requirements.
I regularly collaborate with insurance carriers, attorneys, case managers, and third-party administrators by preparing narrative reports and responding to documentation requests. When I find gaps or inconsistencies, I identify what needs clarification so claims are supported accurately from intake through case monitoring and outcome tracking.
Experience
Work history, roles, and key accomplishments
Clinical Director, D.C.
Healthview Rehabilitation Center PSC
Jan 2000 - Jan 2025 (25 years)
Served as Doctor of Chiropractic and Clinical Director, evaluating auto injury, personal injury, and workers’ compensation cases by reviewing medical records, imaging, and treatment progression to support injury causation and medical necessity decisions for PIP and payer reviews. Produced CPT/ICD-10 coding, utilization review documentation, and narrative clinical reports for insurance carriers, at
Education
Degrees, certifications, and relevant coursework
Northwestern Health Sciences University
Doctor of Chiropractic, Chiropractic
Earned a Doctor of Chiropractic (D.C.) degree from Northwestern Health Sciences University in 1999.
Northwestern Health Sciences University
Bachelor of Science, Human Biology
Earned a Bachelor of Science degree in Human Biology from Northwestern Health Sciences University in 1996.
Availability
Location
Authorized to work in
Job categories
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