Summary
Overview
Work History
Education
Skills
Certification
TRAININGS
QUALITIES
Timeline
AccountManager
JENNY THERESE M. AQUINO

JENNY THERESE M. AQUINO

UM Nurse
Mayamot, Antipolo City

Summary

Utilization Management Nurse focused on medical necessity review, post-service claims analysis, and accurate abstraction of clinical documentation, completing 61+ medical reviews per week. Uses critical thinking and effective communication to support defensible review decisions and timely case resolution. Maintains accuracy under pressure across changing review priorities.

Overview

3
3
Certifications
15
15
years of professional experience

Work History

Nurse Medical Management Post Service ClinicalReviewer

Carelon Global Solutions
Taguig City, Metro Manila
11.2021 - Current

Nurse Associate (UM Nurse, Nurse Abstractor)

EXL Service Inc.
02.2019 - 10.2021

Staff Nurse

Al Osrah Al Shamil Family Polyclinic
03.2011 - 07.2014

Education

Bachelor of Science - Nursing

Araullo University Phinma-Education Network
01-2008

Skills

Post-service clinical claims review

Medical abstraction

Attention to details

Clinical documentation review

HIPAA Protocol adherence

Utilization reviews - Outpatient

Utilization reviews - Ancillary services

Retrospective review

Medical necessity review

Clinical documentation

Clinical judgment

Licensed RN

Benefit determination

Electronic health records management

Compassion and empathy

Team coordination

Can work under pressure

Fast learner

Complex Problem-solving

Data collection

Certification

National Council Licensure Examination – New Mexico June 2019

TRAININGS

  • Medical Virtual Assistant - Medical Billing - June 2026
  • Post Graduate Nursing Program April – August 2016
  • Saint Luke’s Medical Center, Quezon City
  • Basic Life Support Training August 2014
  • Philippine Red Cross, Rizal Chapter, Antipolo City
  • Intravenous Therapy Training Program July 2014
  • Manila Adventist Medical Center, Pasay City

QUALITIES

  • Prioritizes Quality of work
  • Team player
  • Task and Goal-oriented
  • Adaptable/Flexible
  • Dedicated
  • Compassion and empathetic
  • Fast-learner
  • Punctual

Timeline

Nurse Medical Management Post Service ClinicalReviewer

Carelon Global Solutions
11.2021 - Current

Nurse Associate (UM Nurse, Nurse Abstractor)

EXL Service Inc.
02.2019 - 10.2021

Staff Nurse

Al Osrah Al Shamil Family Polyclinic
03.2011 - 07.2014

Bachelor of Science - Nursing

Araullo University Phinma-Education Network
JENNY THERESE M. AQUINOUM Nurse