Summary
Overview
Work History
Education
Skills
Timeline
Generic

RAYMOND HUFF

Clinton Twp.

Summary

I am a reliable, hardworking and passionate job seeker who is ready to help contribute to the success of wherever I am employed. Excellence, growth, development, advancement and success are my pursuits.

Overview

12
12
years of professional experience

Work History

Legal Assistant

JC Auto Accident Law Firm
01.2025 - Current
  • Manages accounts and client records of clients, observing confidentiality, and extreme discretion.
  • Communicates pertinent information to clients via phone, email, and mail.
  • Responds to client inquiries, providing accurate legal advice and offering assistance.
  • Contacts clients to schedule appointments and discuss progress of cases.
  • Researches statutes, decisions, legal articles, and codes.
  • Interviews clients to obtain information relevant to cases.
  • Handled office scheduling and made notes for deadlines, motions, and other important dates.
  • Input data into spreadsheets and databases.
  • Informed and supported business leaders through consistent communication and administrative support duties.

Executive Assistant

Life Eternal Ministries
01.2016 - 01.2025
  • Managed executive calendars, scheduling meetings and appointments and coordinating travel arrangements to optimize time.
  • Handled confidential and sensitive information with discretion and tact.
  • Updated spreadsheets and databases to track, analyze, and report on performance and sales data.
  • Created and managed office systems to efficiently deal with documentation.
  • Volunteered to help with special projects of varying degrees of complexity.
  • Wrote reports, executive summaries and newsletters.
  • Handled logistics, catering, agendas and travel arrangements for meeting and event planning for board of directors, president and executive vice president.

Process Expert I

Elevance Health
06.2023 - 11.2023


  • Provided coordination to all Brokers, customers and internal Key Stakeholders of the progress and potential fallout of this migration to minimize any abrasion to customers
  • Enrolled members into their life and disability benefit selections and reflected the plans in the system
  • Data Entry
  • Assisted in identifying and researching workflow problems and system irregularities
  • Reviewed adjustment requests submitted to Intake site for accuracy and clarified requests with the submitter as appropriate
  • Researched operations workflow problems and system irregularities; assisted with the development and testing of process improvement solutions for new systems, new accounts and other operational improvements; assisted with the development and leading of project plans and communicating project status

Command Center Representative

Elevance Health
05.2023 - 06.2023


  • Received inbound calls from employers and provider groups
  • Assisted with system migration for Life & Disability Insurance
  • Advised of general information
  • Documented phone calls and followed migration phases/flows

Claims Representative

NTT Data
05.2022 - 05.2023
  • Managed large volume of medical claims on daily basis.
  • Set up and examination of received documents, payment calculations and settlement
  • Performed check tracing and investigation of payment (i.e. ACH)
  • Ensured compliance with company regulations standards regarding quality assurance procedures.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
  • Eligibility verification of members claims/treatment/care
  • Reviewed prior authorizations
  • Performed additional adjudication covering review of medical history before proceeding with medical benefits
  • Paid or denied medical claims based upon established claims processing criteria.

Claims Resolution Specialist

Integra Partners, LLC.
10.2019 - 11.2021


  • For this role, I used problem solving skills and planning abilities to diagnose and solve root process, payer and communicate system issues impacting revenue cycle objectives
  • I am familiar with ICD-10, HCPCS and medical terminology
  • Being knowledgeable of the 1500 and UB-04 claim forms, as well as DMEPOS are things I am versed in
  • Collected information about rejected claims and developed effective solutions
  • Reads over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials
  • Documented all information gathered in claim notation software
  • Analyzed current business plan, identifies inefficiencies in existing processes, and tracks performance following implementation of improvements

Associate Rep, PIRR

Molina Healthcare
01.2018 - 07.2019


  • In this position, I resolved and prepared written responses to incoming provider reconsideration requests relating to claims payments and requests for claim adjustments or to requests from outside agencies
  • Received and examined provider documentation submitted to be credentialed within network
  • Reviewed appeals and grievances to resolve provider disputes
  • I researched claim processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error
  • I improved quality processes for increased efficiency and effectiveness
  • I assisted with proactive client outreach initiatives through correspondence and documented client correspondence in an internal database input system

Member Service Representative

Molina Healthcare
04.2016 - 01.2018


  • Provided service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to: phone, chat, email, and off phone work to support Medicaid, Medicare and/or Marketplace business
  • Informed members of HEDIS alerts and followed up to ensure relevant doctor visits were scheduled
  • Adhered to all HIPAA, PHI, Compliance and Quality standards
  • Reviewed prior authorizations for services/procedures/medications to be approved or denied
  • Informed members of their various health benefits and answered questions in regards to them, including pharmaceutical
  • Assisted with enrollments in benefit plans and coordinated member enrollment with the health insurance marketplace
  • Conducted various surveys related to health assessments and member/provider satisfaction
  • Supported provider needs for basic inquiries and assistance involving member eligibility and covered benefits, Provider Portal, and status of submitted claims

Assistant Manager

Burger King
02.2016 - 04.2016


  • Being an Assistant Manager entailed me directing the preparation and sale of products for prompt delivery within established speed of service guidelines
  • I supervised, as well as trained team members and Shift Coordinators on team stations, BKC products, processes and policies
  • As part of the restaurant management team, I took part in recruiting, hiring, and training to retain effective team talent by making decisions or recommendations on hiring and advancement
  • Additionally, I followed cash control/security procedures and help to implement marketing plans, maintain inventory, manage labor, and apply financial reports across shifts to enhance restaurant results
  • Managed inventory control processes to restore back stock, control costs and maintain sales floor levels to meet customer needs
  • Supported staff development and goal attainment by focusing on skill development and job satisfaction
  • Generated repeat business through exceptional customer service and responded to customer concerns with friendly and knowledgeable service

Service Desk Analyst

CareTech Solutions
03.2015 - 09.2015
  • Received incoming calls from the client community and provided first level support
  • Documented each call, verified customer information, and included all troubleshooting steps
  • Responsible for researching, resolving, and responding to questions received via telephone calls, emails, and callbacks in a timely manner, in accordance with standards
  • Entered service tickets into incident tracking system to facilitate faster problem identification and resolution.
  • Escalated problems to the appropriate individual/group
  • Provided accurate and creative solutions to user problems of moderate nature to ensure user productivity
  • Acquired and maintained current knowledge of relevant product offerings and support policies to provide technically accurate solutions to customers
  • Attended training sessions as required and participated in team projects that enhanced the quality or efficiency of the Service Desk
  • Assisted with special product-related issues as needed and maintained files and records by implementing effective filing systems that boosted efficiency and organization

ASSISTANT STORE MANAGER

PacSun
10.2014 - 02.2015
  • Company Overview: Company Overview: Sterling Heights, MI
  • Managed associates and ensured effective sales floor performance
  • Reviewed and designed floor plans
  • Opened and closed the store
  • Calculated payroll, created schedules, and conducted interviews
  • Rung shoppers orders at the registers and handled cash, credit/debit and check transactions
  • Counted registers, filled out paperwork, and maintained documentation
  • Assessed job applications and made hiring recommendations
  • Reduced company expenditures and met budget targets
  • Reviewed performance data and monitored productivity such as KPIs
  • Rotated merchandise and displays

DEPARTMENT MANAGER

Wal-Mart
01.2014 - 10.2014
  • Company Overview: Company Overview: Warren, Michigan
  • Spearheaded the boys clothing department
  • Stocked the sales floor, ordered merchandise, supervised and labored with associates in the apparel department
  • Maintained an atmosphere of catering to customers while still being proficient and effective at tasks
  • Had the vision and design for the department and ensured the area was neat, stocked with merchandise, clean, friendly, and up to expected standards of customers and superiors
  • Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions
  • Applied performance data to evaluate and improve operations, target current business conditions, and forecast needs
  • Kept employee workloads fair and balanced to achieve objectives while maintaining high job satisfaction
  • Reduced waste and pursued revenue development strategies to keep department aligned with sales and profit targets
  • Managed inventory and receiving operations to maintain optimal stock levels and meet expected demands

Education

High School Diploma - undefined

Paul K. Cousino High School
05.2015

undefined

Macomb Community College
06.2012

Skills

  • Processes
  • Medical Terminology
  • Sales
  • Written and oral report creation
  • Troubleshooting and problem resolution
  • Microsoft Office
  • Policies
  • Claims investigation and research
  • Research and reporting
  • Customer service

Timeline

Legal Assistant

JC Auto Accident Law Firm
01.2025 - Current

Process Expert I

Elevance Health
06.2023 - 11.2023

Command Center Representative

Elevance Health
05.2023 - 06.2023

Claims Representative

NTT Data
05.2022 - 05.2023

Claims Resolution Specialist

Integra Partners, LLC.
10.2019 - 11.2021

Associate Rep, PIRR

Molina Healthcare
01.2018 - 07.2019

Member Service Representative

Molina Healthcare
04.2016 - 01.2018

Assistant Manager

Burger King
02.2016 - 04.2016

Executive Assistant

Life Eternal Ministries
01.2016 - 01.2025

Service Desk Analyst

CareTech Solutions
03.2015 - 09.2015

ASSISTANT STORE MANAGER

PacSun
10.2014 - 02.2015

DEPARTMENT MANAGER

Wal-Mart
01.2014 - 10.2014

High School Diploma - undefined

Paul K. Cousino High School

undefined

Macomb Community College

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