Lakeisha Bussey
Austin,TX
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
15
15
years of professional experience
Work History
Insurance Verification Specialist
CHS
07.2025 - 10.2025
- Collaborate with Front Desk, Scheduling, and Clinical Operations teams to complete assigned tasks.
- Monitor voicemail to properly follow-up with patient inquiries in a timely manner.
- Communicate with patients and Aspire staff regarding out-of-pocket cost estimates and financial responsibility as well as authorization requirements.
- Review demographic and insurance information in patient accounts and make necessary corrections.
- Follow policies and procedures to contribute to the efficiency of the business office.
- Completes accurate and timely insurance verification for patient visits/procedures/testing in accordance with company policy, workflow, and department goals.
- Completes accurate and timely third-party payer authorization requests, including ensuring all necessary data elements needed for an authorization (e.g., CPT codes, diagnosis codes) are available.
- Ensures services scheduled by the scheduling team have approved authorization as required by payer and procedure prior to service.
- Refers underinsured/uninsured patients to the Billing Specialists to see if the patient is eligible for assistance or offer payment options prior to services being received.
- Creates a positive patient experience by being polite, compassionate, and professional.
- Provides cross-coverage and training, when needed, for other team members.
- Maintains productivity and quality performance expectations.
- Regular attendance is required to carry out the essential functions of the position.
- Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge, and abilities to perform, within scope, role specific functions.
Patient Access Service Representative
RemX
12.2023 - 07.2025
- Answer inbound calls and make outbound calls related to patient scheduling, registration, and service inquiries. Triage patient needs and route calls to appropriate departments.
- Verify patient insurance eligibility, benefits coverage, and co-pay/deductible requirements. Contact insurance companies and use payer portals for up-to- date benefits information.
- Obtain and track prior authorizations and referrals for procedures, diagnostics, and specialist visits. Follow up with providers and payers to avoid delays in patient care.
- Assist uninsured patients in exploring Medicaid, charity programs, or financial aid options. Provide front-end support for patient billing inquiries.
- Filled patients prescriptions and having it delivered.
Medical Claims Processor
United Healthcare Group
12.2019 - 12.2023
- Review, process, and follow up on medical claims submitted by providers, patients, and payers. Analyze claims for accuracy, eligibility, coding (ICD-10, CPT, HCPCS), and completeness.
- Resolve denied, pending, or rejected claims by investigating and correcting issues or communicating with relevant parties.
- Handle high-volume inbound chat interactions from patients, providers, and insurance representatives. Respond to inquiries regarding claim status,
Explanation of Benefits (EOBs), patient balances, and payment information. - Accurately document all chat interactions, claims activity, and resolution steps in the appropriate systems (e.g., CRM, EHR, practice management software).
Appointment Scheduling Specialist
Baylor College Of Medicine
08.2015 - 12.2019
- Answer and manage a large number of incoming calls from patients, family members, and healthcare providers. Prioritize urgent scheduling requests appropriately.
- Schedule, reschedule, confirm, or cancel patient appointments across multiple departments or specialties. Coordinate with internal departments to ensure appointment availability aligns with provider schedules.
- Collect and verify insurance information prior to scheduling appointments. Confirm patient eligibility and obtain necessary pre-authorizations or referrals as required.
- Operate scheduling tools and EMR platforms (e.g., Epic, Cerner, Meditech). Maintain scheduling accuracy and ensure all updates are logged properly.
Medicare Customer Service Representative
Sutherland Global
05.2010 - 08.2015
- Answer 75–120+ inbound calls daily from Medicare beneficiaries, caregivers, and providers regarding healthcare benefits, plan options, and coverage.
- Educate callers on Medicare Advantage (Part C), Prescription Drug Plans (Part D), Medigap (Supplemental Plans), and Original Medicare (Parts A & B).
- Guide beneficiaries through the enrollment process, verify eligibility, assist with Special Enrollment Periods (SEPs), and explain plan changes. Help members understand what services are covered, check the status of claims, explain EOBs (Explanations of Benefits), and resolve billing questions.
- Research and resolve concerns such as coverage denials, premium billing issues, ID card replacements, pharmacy network problems, or provider access.
Education
High School Diploma -
King High School
Corpus Christi, TX05.1998
Skills
- HIPAA compliance
- Appointment scheduling
- Patient confidentiality
- Claims processing
- Medical billing
- Policy adherence
- Referral coordination
- Empathy and patience
- Data entry
- Email Support
- Inbound/Outbound Calling
- Chat Support
- Epic
- Medicare
- Patient payment processing
- EMR
- Insurance billing
- Remote Operations
- Customer service excellence
- Payment processing
- Call center operations
- Enrollment processing
- Eligibility determination
- EOB analysis
- CPT, CDT, ICD-10, HCPCS Codes
Timeline
Insurance Verification Specialist
CHS
07.2025 - 10.2025
Patient Access Service Representative
RemX
12.2023 - 07.2025
Medical Claims Processor
United Healthcare Group
12.2019 - 12.2023
Appointment Scheduling Specialist
Baylor College Of Medicine
08.2015 - 12.2019
Medicare Customer Service Representative
Sutherland Global
05.2010 - 08.2015
High School Diploma -
King High School