August Sessom

Longview

Summary

Detail-oriented healthcare support professional with experience in data entry, claims processing, prior authorization intake, and multi-channel customer support. Proven ability to manage high-volume requests, maintain accurate medical documentation, and support members and providers through phone and chat communication. Experienced in working with healthcare systems, medical/billing terminology, eligibility verification, and HIPAA-compliant documentation. Strong multitasking and problem-solving skills with a consistent record of meeting productivity, quality, and service-level metrics in remote and fast-paced environments.

Overview

years of professional experience

Certification

Work History

Inbound Contacts Representative

Humana

09.2024 - 11.2026

Managed high-volume inbound communications assisting members and providers with claims inquiries, benefits verification, billing questions, and account updates.
Performed accurate data entry and documentation of member information, claim details, and service notes into internal CRM systems.
Researched and reviewed insurance claims, eligibility records, and policy guidelines to resolve customer issues and ensure proper claim processing.
Provided chat and phone support, delivering real-time assistance while maintaining productivity and customer service standards.
Maintained detailed records of all customer interactions in compliance with HIPAA and company documentation requirements.
Identified claim discrepancies and escalated complex cases to appropriate departments for timely resolution.
Utilized multiple internal systems simultaneously to retrieve, verify, and update member records.
Consistently met or exceeded performance metrics including correct documentation, customer satisfaction, and resolution time.

Intake Specialist/ Team Leader

Cohere Health

07.2022 - 05.2024

Processed high-volume prior authorization and intake requests from healthcare providers, ensuring accurate case creation and timely processing.
Performed detailed data entry of patient demographics, provider information, ICD-10 diagnosis codes, and insurance details into internal healthcare management systems.
Reviewed provider submissions for medical code accuracy, medical necessity indicators, and required clinical documentation to support authorization and claims workflows.
Verified member eligibility, benefits coverage, and service requirements while maintaining compliance with payer guidelines and healthcare regulations.
Served as team leader for intake staff, providing workflow guidance, training assistance, and quality oversight to maintain productivity and documentation standards.
Monitored intake queues and workload distribution to ensure timely processing of authorization requests and adherence to service-level agreements (SLAs).
Communicated with provider offices to obtain missing documentation, clarify diagnosis codes or procedure information, and resolve intake discrepancies.
Maintained detailed case notes and records in accordance with HIPAA privacy standards and healthcare documentation policies.
Collaborated with utilization management teams, clinical reviewers, and claims departments to support accurate authorization and case processing.
Consistently exceeded performance metrics including data accuracy, turnaround time, and quality assurance compliance.

Education

High School Diploma -

Longview High School

Longview, TX

02-2020

Skills

Typing Speed: 65 WPM
Oral and Written Customer Support
Time and stress management
Adaptability
Claim Handling
Data Entry
Prior Authorization Processing

Intake Coordination
Problem solving
Medical Terminology and Documentation Knowledge
CRM and B2B Software Experience
Microsoft and Google Services Experience
Electronic Health Records (EHR)

Websites

www.linkedin.com/in/august-sessom-893380304