James Fellinger Email & Phone Number

Greater Grand Rapids, Michigan Area

Manage the medical and pharmacy appeal process for our Medicare Advantage members. Each case usually has a unique twist and gets our full attention so that each member’s issue is investigated fully and reviewed properly. At the end of the process, good news is delivered with gusto and not so good news with respect and compassion.

Greater Grand Rapids, Michigan Area

Collaborate with patients, medical teams and health plans seeking treatments for chronic or rare disease states. The Meijer Specialty Pharmacy serves customers in all 50 states by guiding them through the process of referral, prior authorization, appeals, and ongoing counseling, to help our patients and their families feel better.

Greater Grand Rapids, Michigan Area

Contact individual leads via inbound and outbound telephone calls to generate new customers for Medicare, life, dental, and vision plans. • Consistently recognized as a “Top 5” weekly producer. • Completed credentialing process for multiple national carriers.

Greater Grand Rapids, Michigan Area

Directed a team of health plan professionals responsible for investigating, resolving, and tracking Medicare grievances and appeals filed by Medicare Advantage plan enrollees. • Chaired the Priority Health Medicare Appeal Committee• Achieved a team performance resulting in 99.5% rate for case completion.• Consistently earned Medicare 5-Star ratings for appeal case quality.• Improved process efficiencies resulting in increased case volume per coordinator.

Completed daily sales contacts with potential enrollees and consulted with independent agents to generate new business and drive sales growth.• 83% close rate for incoming sales calls.• Direct involvement with implementing strategies that resulted in 21,000+ new customers during AEP.

Led a team of 10 individuals to implement strategies for incentive programs, new product launches, customer relationship management, and support for multi-cultural initiatives. Responsible for 1500 high volume accounts in the US market, half of which were multi-cultural consumer segments.• Conducted weekly team meetings and monthly individual meetings with staff resulting in lower training time for team assignments.• Designed and presented strategic business presentations for audiences up to 20,000.• Directed a sales team having highest combined evaluation scores in the department.

Ada, Mi

Completed weekly proactive calls to business owners as needed to promote new products, market support services, and to establish new relationships with the objective of increasing revenue. • Recognized as one of the “Top Performers” in the department for consistently producing the most calls during peak business cycles.Prior to Sales, I was in Business Conduct and Rules: Monitored and enforced rules of conduct for independent business owners in the US. Partnered with internal and external teams to develop new policies and guidelines to help business owners increase revenue.

As a crew leader, guided a team of security professionals on access control, employee safety, fire protection, executive security and loss prevention.

Started in the Men's Clothing and Shoes departments. Completed the Management Training program and moved to the Internal Audit department where we measured compliance with company policies involving efficiency of operations, financial reporting, safeguarding assets and compliance with laws and regulations.

Master Of Management, Strategic Planning, Organization Behavior And Leadership

B.A., Social Sciences

A.A., Criminal Justice

College Prep

Activities and Societies: Varsity club, school newspaper, band and sports.