Karen Klaire T. Terania, R.N

#333 South Star Plaza, Osmeña Highway Makati City/ 09152456918/ [email protected]

Objective:
To attain a responsible position and fully utilize my knowledge and capability in those areas wherein my integrity and dedication will contribute to the achievement of the company goal.

Education
• Our Lady of Fatima University
Bachelor of Science in Nursing
2010

Professional History

• United Health Group
Optum Global Solution (BOM)
Pharmacy Benefits Analyst
September 2012- Present

Job Description:

• Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.
• Research and respond to all claims processing inquiries from client management, clinical and other internal department
• Develop and run macros to implement plan requests

Certifications

• Registered Nurse, Professional Regulatory Commission

• Licensed Intravenous Nurse

Trainings and Seminars

• Lean Training
United Health Group, Taguig City
August, 2016

• SIX SIGMA WHITE Belt Training
United Health Group, Taguig City
September 2012

• Intravenous Therapy Training
Metro South Medical Center, Cavite
May 2011

• Business Writing Skills
United Health Group, Taguig City
September 2015

• Fraud and Abuse Annual Training
United Health Group, Taguig City
June 2019

• Professional Etiquette & Client Interaction Skills
United Health Group, Taguig City
August 2016

Achievements and Awards

• Opal Award
UHG-November 2015

• Team Top Performer
UHG- September 2016
• Opal Award
UHG-November 2019

Character Reference

• Louie Lachica
Certified Medical Coding Specialist, Chart Operations
09162384881

• Japhet Navarro
Subject Matter Expert – Optum Global Solutions
09778101114

• Maylene Garcia
Coach – Optum Global Solutions
09163087475

I hereby certify that the above information are true and correct to the best of my knowledge.

____________________

Terania, Karen Klaire T.