Charmaine Valenzuela

Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.

Recovery Resolutions Representative at Optum (2020-05 – 2025-03)

• Conducted thorough reviews of triage and ICD codes to ensure accurate patient claims management.
• Resolved complex billing inquiries to enhance customer satisfaction and retention.
• Analyzed account discrepancies to ensure accurate and timely resolutions for clients.
• Collaborated with cross-functional teams to streamline recovery processes and improve efficiency.
• Managed high-volume caseloads while maintaining compliance with regulatory standards.
• Developed training materials to improve team performance in customer interactions.
• Implemented process improvements that reduced resolution time for outstanding accounts.

Clinical Data Abstractor at Optum (2019-07 – 2020-05)

• Abstract clinical data from electronic health records to ensure accuracy and compliance with regulatory standards.
• Strengthened the accuracy of clinical studies with careful attention to detail while abstracting relevant patient data.
• Reviewed patient charts to extract relevant information, supporting research initiatives with accurate data.
• Implement improvements in data abstraction methodologies, leading to increased reliability of clinical outcomes reporting.
• Mentored junior abstractors in best practices for data extraction and quality assurance, enhancing overall team capability.

Pharmacy Benefits Analyst at Optum (2018-07 – 2019-01)

• Performed detailed analysis and coding to ensure accurate and efficient pharmacy plan formulation.
• Coordinated wellness initiatives that promoted a healthy work environment.
• Analyzed employee benefits data to identify trends and recommend program enhancements.
• Developed and maintained detailed documentation for benefits policies and procedures.
• Collaborated with cross-functional teams to streamline benefits administration processes.

Pharmacy Benefits Analyst at Optum (2016-06 – 2017-01)

Certificate in Professional Course in Education Major in Biological Science – College of The Most Holy Trinity Catholic Foundation Inc (2023-05 – 2023-05)

Bachelor of Science in Pharmacy – Our Lady of Fatima University (2015-10 – 2015-10)