JEROME C. CHAMBERS
Miamisburg,OH
Summary
MBA graduate with 12 years account management, operations, marketing, sales and implementation experience in the healthcare industry. I am very familiar with Medicare, Ohio Medicaid, and Commercial Insurance. Also 4 years’ experience as an independent network technician installing cable and other IT items to upgrade / build out MDF / IDF rooms and or closets for various clients. I have worked with Chase Bank, IKEA, Hilton/Marriott, Traders Joes, and P & G, on various projects. Licensed Insurance Agent: Life, Health, Annuities, Property and Casualty Experience includes: Microsoft Word, Excel and PowerPoint, Cisco and Aruba Switches, Ap’s, (Installation of cameras, routers, modems, and firewalls in MDF and IDF rooms/closets)
Overview
19
19
years of professional experience
Work History
IT Independent Contractor
Self - Employed
03.2022 - Current
- Produce flux rings used on AC units
- Operate 5 axis CNC machine to maintain proper ID, OD, width, and flux gap
- Adjust the feed, point, pitch, cut, diameter as needed to bring part in proper specs when adjustments are required
- Produced 150,000 to 200,000 rings per shift
- Maintained scrap level at less than 3.5% per shift
- Inspect parts every ½ hour to maintain proper tolerances of part specs
- Complete a daily production report of parts produced, scrap amount and scrap source
- Replace and recalibrate worn blades on machine as deemed necessary (generally 2 to 4 times per shift)
Independent Medicare Agent
United Healthcare
07.2017 - Current
- Developed sales presentations to a large number of clients every month, with a high conversion ratio
- Provided one-on-one services to clients to meet their healthcare goals through customized packaging
- Achieved a 97% retention rate
- Maintained compliance with state and federal regulations
- Research market/identifying leads, prepares marketing plans
- Part-time Sales Agent
Revenue Recovery Representative
Ensemble Health Partners
03.2019 - 03.2022
- Client: Mercy Health Hospital System
- Became very familiar with payer contracts (commercial, Medicare and Medicaid) for technical claim underpayments
- Submitted reconsiderations to obtain underpaid inpatient and outpatient claims
- Examine denied and underpaid claims to determine the reason for discrepancies
- Identified several system and process trends and addressed the root causes of the issues
Network Contract Specialist
Aetna
04.2014 - 05.2017
- Manage, developed, and maintained providers’ network in 6 Southwest Ohio Counties Montgomery, Greene, Clark, Warren, Butler, Hamilton
- Company representative in community outreach/forums, provider training/seminar/conferences, and government forums
- Managed external contracting activities and coordinate internal contracting processes including credentialing and provider loading to claims systems
- Negotiated rates and language for provider agreements and single case agreements for in and out-of-network providers
- Performed analysis on payment and utilization data to renegotiate financially viable contracts with high utilization facilities and control medical cost trends
- Mentored new provider department staff in network strategic planning and contracting
Group & Individual ACA Agent
CareSource
09.2007 - 04.2014
- Conducted sales presentations to a large number of clients monthly with a 50% conversion ratio
- Company representative in community outreach events and conferences
- Made calls (phone and in person) to small business owners to set appointments for face-to-face meetings
- 8 months
Marketing Specialist
CareSource
09.2007 - 04.2014
- Drafted and designed company sales and marketing materials
- Participated in comprehensive forums to increase the website presence and utilization
- Collected data of potential customers for different projects
- 1 year – 3 months
Agent Broker Manager
CareSource
09.2007 - 04.2014
- Recruited, trained, and managed 33 Medicare Independent Agents
- Developed a broker agent compliance, training, and contracting process manual
- Developed sales and marketing strategies to exceeded annual sales goals
- Developed and Conducted quarterly agent ride-along and corporate training
- Ensured commissions were paid accurately and timely
- 2 years – 2 months
Medicare Account Manager
CareSource
09.2007 - 04.2014
- Set up and implement marketing plans
- Established a referral system by creating a customer service follow up program
- Trained new account managers, brokers and new hires in other departments
- Developed a grass root marketing strategies for the Dual Medicare Advantage product (Initially 17 Ohio counties)
- Increased the plan growth managing the broker relationships (33) and oversight in Ohio and Michigan
- Developed relationships with external stakeholders in the public housing sector, providers and community agencies
- 2 years – 5 months
Education
MBA - Healthcare Administration
Indiana Wesleyan University
04-2012
Skills
- Client relationship building
- Educational events
- Workload management
- Deadline adherence
- Insurance compliance
- Troubleshoot and problem solving
Timeline
IT Independent Contractor
Self - Employed
03.2022 - Current
Revenue Recovery Representative
Ensemble Health Partners
03.2019 - 03.2022
Independent Medicare Agent
United Healthcare
07.2017 - Current
Network Contract Specialist
Aetna
04.2014 - 05.2017
Group & Individual ACA Agent
CareSource
09.2007 - 04.2014
Marketing Specialist
CareSource
09.2007 - 04.2014
Agent Broker Manager
CareSource
09.2007 - 04.2014
Medicare Account Manager
CareSource
09.2007 - 04.2014
MBA - Healthcare Administration
Indiana Wesleyan University