Tracey Larrañaga
Albuquerque,NM
Summary
Hard-working professional with 15.5+ years of experience and proven knowledge of service delivery and integrated health care delivery. Aiming to leverage my skills to successfully fill a leadership role within the company.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Sr. Implementation Analyst
Health Care Service Corporation, HCSC
Albuquerque, NM
08.2015 - Current
- Lead client focused implementations for new and renewing accounts, new legislation and products across the Enterprise.
- Manage implementation activities of moderate to high complexity and keep Sales and Account Management informed of strategic trends in product life cycle management.
- Cultivates partnerships with other HCSC business areas, in addition to developing external client relationships.
- Responsible for communications and implementation artifacts that provide the progress, issues, and risks surrounding the project.
Marketing Service Representative
Health Care Service Corporation, HCSC
Albuquerque, NM
12.2013 - 07.2015
- Prepare group benefit paperwork for requested proposals and Request for Proposals (RFP's) and submit to Underwriting for proposed rates.
- Serve as primary point of contact for new/renewing contracts, assist in managing billing inquiries and handle account concerns/issues.
- Provide weekly large group activity and sales to Senior Leadership.
- Responsible for providing support to Account Executives in meeting marketing retention targets while maintaining relationships with producers and group leaders.
- Present benefit materials and represent Blue Cross Blue Shield of NM at employee health fair and benefit presentations.
Membership Specialist
Health Care Service Corporation, HCSC
Albuquerque, NM
11.2012 - 12.2013
- Processed daily electronic membership files for high profile NM large group accounts.
- Worked on complex eligibility issues with Customer Service Advocates and Claims Examiners.
- Collaborated with NM Sales and Marketing team on vital membership reporting.
- Maintained membership database, ensuring that all information was current and accurate.
- Identified issues and immediately stepped up to guarantee speedy and effective resolutions.
Claims Examiner
Health Care Service Corporation, HCSC
Albuquerque, NM
06.2010 - 11.2012
- Processed start-to-finish claims through the ITS system and in coordination with other BCBS plans.
- Promoted to IBAC team to process multiplex claims while meeting quality measurements set by Performance Guarantees.
- Exceeded stringent performance standards.
- Mentored new employees to ensure compliance with performance and production standards.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
Customer Service Associate
Express Scripts Pharmacy
Albuquerque, NM
08.2003 - 02.2010
- Customer Service Advocate responsible for servicing pharmacists and members to guarantee quality assurance and customer service satisfaction.
- Improved efficiencies by educating veteran employees on new system procedures and policies to include accurate pharmacy regulations.
- Responsible for community outreach and building strong relationships within the community.
- Worked hands on in the back-end pharmacy by entering prescription information sent directly to contracted pharmacists.
- Effectively trained Customer Service Advocates; mentored and supported more than 10 customer service teams.
Education
Associate of Business Administration - Business Administration Undergraduate
University of New Mexico
Albuquerque, NMSkills
- Leadership
- Multitasking abilities
- Interpersonal Communication
- Organization and Time management
Certification
Producer License | August 2014 | State of New Mexico
- Life, Accident and Health Insurance
Timeline
Sr. Implementation Analyst
Health Care Service Corporation, HCSC
08.2015 - Current
Marketing Service Representative
Health Care Service Corporation, HCSC
12.2013 - 07.2015
Membership Specialist
Health Care Service Corporation, HCSC
11.2012 - 12.2013
Claims Examiner
Health Care Service Corporation, HCSC
06.2010 - 11.2012
Customer Service Associate
Express Scripts Pharmacy
08.2003 - 02.2010
Associate of Business Administration - Business Administration Undergraduate
University of New Mexico
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