Hilda Garibay
Stockton,CA
Summary
Dynamic Associate Account Manager at Acrisure with expertise in Open Enrollment and Employee Benefits and Compliance. Proven track record in delivering consultative analysis and enhancing client satisfaction. Skilled in multiple systems including Workday and ADP, while effectively training teams. Adept at interpreting policies and procedures ensuring regulatory adherence, fostering informed decision-making for clients. Well versed in all aspects of health and welfare benefits including voluntary benefits.
Overview
13
13
years of professional experience
Work History
Associate Account Manager
Acrisure
09.2024 - 2025
- As an Associate Account Manager, I am tasked with multiple activities which include quoting, renewal support, and project management. I am responsible for interpreting and converting Open Enrollment materials into a nice presentation for employees to view. I am responsible for creating all the Benefit Guides and ensuring all the data is accurately stated based on contracts received from the insurance carriers.
- I am assigned to multiple clients where I am the first point of contact for any benefit related questions, claims, or prescription benefits.
- In addition, I process all benefit updates and changes, including qualifying life events. I provide a consultative analysis of benefit offerings available to employees and HR when they are making decisions on which plans to enroll in.
Benefit Advocate Lead
Alliant
02.2018 - 04.2024
- Excellent Client servicing in all day-to-day interactions.
- SME: Complex benefit scenarios and claims.
- Renewals and new business implementation.
- Benefit Specialist supporting and servicing multiple Clients, HR, and employees.
- Reviewed explanation of benefits for claims processed and resolved discrepancies with the billing provider and insurance carrier. Processed all changes and obtained necessary supporting documentation on life events, medical and child support notices, new hire, terminations, and COBRA.
- Answered calls live, responded to voicemails and emails promptly. Provide support to Sales and Account Management when needed. Ran various reports for auditing and comparison against carrier activity, and Broker records.
- Provided policy interpretation and adhered to compliance standards with federal regulations related to employee benefit programs such as HSA, FSA, COBRA and HIPPA.
- As a Lead, trained and assisted internal employees with HRIS systems, best practices, procedures, workflows, and escalations requiring expert knowledge and problem resolution.
- Checked employees' benefits enrollment for accuracy and input all data into Clients Benefit Administration System.
- Explained benefits to plan participants in easy-to-understand terms to educate on available options so they could make informed decisions.
- Observed strict procedures to maintain data and plan participant confidentiality.
- Analyzed and reported on employee benefits data to identify trends and develop strategies for improvement.
- Coordinated with HR and Client Service team on employee orientations to promote understanding of coverage and options
Sr. Customer Care & Claims Representative
Blue Shield of CA
12.2010 - 08.2016
- Extensive related experience in Health and Welfare Benefit Plans, including Voluntary Benefits.
- Provided thorough review of benefits and how they were applied to claims.
- Reviewed Evidence of Coverage booklets to define and interpret policies and procedures.
- Assisted with eligibility, claims, and billing discrepancies
- As a Resolute Premier Account Specialist, I provided exceptional 'above and beyond' assistance and support to all inquiries.
- My daily interactions with Clients and Customers consisted of managing all inquiries and providing resolution and options to escalated and complex issues.
- Consistently provided mentorship and training to new
Skills
- Open Enrollment and Eligibility
- Health Plan Benefits
- Benefit Administration on multiple systems
- Eligibility Determinations
- Knowledge of multiple systems: Workday, ADP, PlanSource, Ease, UKG, Paycom and many more
- Employee Benefits Compliance and Regulation
- ACA
- Policy Interpretation
- Regulatory Monitoring
- Voluntary Benefits
- COBRA
- Consultative Techniques
- HR Compliance and HIPPA
Timeline
Associate Account Manager
Acrisure
09.2024 - 2025
Benefit Advocate Lead
Alliant
02.2018 - 04.2024
Sr. Customer Care & Claims Representative
Blue Shield of CA
12.2010 - 08.2016