Adriana Villalobos

Carson,NV

Summary

Smart Contract Administrator with solid background working in highly dynamic and complex business environments. Strong analytical and negotiation skills with keen eye for complex data. Reliable, committed and eager to help organization achieve objectives.

Overview

years of professional experience

Work History

Lead Contract Administrator

Prominence Health Plan

06.2019 - 07.2023

Initiate, negotiate, generate, redline, and track single case agreements, interims, contracts and amendments with hospitals, physician groups, and ancillary providers.
Clearly and professionally communicate contract terms and reimbursement rates with providers.
Coordinated preparation and routing distribution of credentialing documents and execution of the agreement to complete the contracting process.
Supported network with developing, maintaining and expansions throughout markets, including researching, recruiting, and completing cost saving analysis.
Conducted contract strategy meetings to identity issues, rate & redline discussions, and obtain senior management approval.
Provided support in developing, implementing and training for the Contracting department.
Built and maintained fee schedules, including auditing and analyzing configuration issues.
Maintained continuous communication with providers via email and/or phone regarding questions or concerns with claim disputes, contractual obligations, benefits, credentialing, portal set up or errors, prior authorizations, etc.

Lead Patient Service Representative

Carson Medical Group

01.2019 - 01.2020

Managed patient registration process, confirming data accuracy, verified insurance eligibility and coverage for patients.
Provided exceptional customer service to patients, answering questions and addressing concerns.
Answered incoming calls, scheduled appointments using eClinicalWorks and filed medical records.
Trained new staff on filing, phone etiquette and other office duties.
Took copayments and compiled daily financial records.

Supervisor

Surf Thru Inc.

03.2017 - 01.2019

Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
Monitored workflow to improve employee time management and increase productivity.
Evaluated employee performance and coached and trained to improve weak areas.

Education

Bachelor of Science - Health Administration

Grand Canyon University

Phoenix, AZ

06.2025

High School Diploma -

Carson High School

Carson City, NV

06.2018

Skills

Contract Redline Review and Edits
Network Monitoring and Development

Staff Education
Senior Leadership Support

Timeline