Sureya Villalobos
Chino
Summary
Results-oriented leader offering proven success as hands-on Director with over 16 years of experience specializing in Revenue Cycle Management, cash flow acceleration, and process improvement. Proven expertise in EPIC billing implementation, staff development (including union-represented team), contract management, and denials management. Skilled in bridging gaps between departments to enhance collaboration and operational efficiency.
Overview
32
32
years of professional experience
Work History
Assistant Director
UCLA Health Systems
Los Angeles
07.2008 - Current
- Responsible for managing 4 Senior Managers, 3 Supervisors, 1 Analyst, and 50 employees: 1 supervisor, 50 collectors, and clerical support.
- Responsible for developing and implementing billing and collection policies and procedures.
- Partnered with Revenue Cycle, Patient Access, Revenue Integrity, Coding Contract Management, Case Management, and Finance to align workflows with payer contracts, improving collections efficiency.
- Fostered partnerships with top payors, enhancing collaboration and increasing successful claims processing for improved revenue generation.
- Provided strategic oversight and mentorship to diverse teams, cultivating a culture of compliance and operational excellence within the Revenue Cycle.
- Led in working with EPIC team to build all claim scenarios, Claim Edits, Discharge Not Bill Edits, Work Queues, and Denial Management BDC Workflows - testing, implementation, monitoring, continuous development, and sustainability.
- Led implantation of Ricoh digital technology to help optimize workflows, enhance productivity, and foster meaningful collaboration.
- Progressively increased average monthly cash collections within the last year from $301M (monthly) to $347M (monthly) by partnering with all key departments in Revenue Cycle and Management team.
- Efforts put forth in implementing billing edits, reducing billing backlogs, training to staff, employee retention, building relationships with a variety of departments, daily active Management, on-going process improvements, active participant in denials management trending and solutions and consistently meeting Goals as established.
- Ability to manage a Union Represented Unit of 50 staff members - Staff development, conflict resolution, Problem-solving, listening, training, mentoring, delegation, patient, vendor, and fiscal intermediaries’ interactions.
- Optimized contract compliance monitoring by implementing payer performance dashboards, identifying denial trends, and initiating process changes that cut underpayments.
Recovery Auditor, Denial Management Supervisor Patient Financial Services
Cedars Sinai Medical Center
Los Angeles
02.2000 - 06.2008
- Responsible for auditing Managed Care, Commercial, PPO accounts to ensure proper payment per contract.
- Escalate any new trends or delay tactics that are impacting our revenue to management.
- Contacting Provider Relations addressing any issues for resolution.
- Appealing underpayments with a timely follow for quicker resolution and providing any additional information requested by Insurance Carrier to expedite the processing of our claims.
- Responsible for addressing three process improvements per quarter to help increase cash revenue.
- Responsible for high volume of special projects to assure recovery of lost revenue within a timely manner.
- Direct reporting to Senior Leadership with findings.
- Direct liaison with payers in resolving underpayment issues, delay tactics, and massive account review.
- Responsible for maintaining current reports to capture any current underpayments and addressing payers of their system limitations delaying cash flow.
- Strengthened payer relations by launching monthly joint-operating meetings with top commercial and government payers, reducing disputes and streamline operations as required to avoid future state denials.
- Responsible for addressing and resolving contract disputes issues regarding misinterpretation of our contract terms as they apply to reimbursement.
Admitting Representative, Patient Financial Services
Pomona Valley Hospital Medical Center (Healthcare Financial Inc.)
01.2000 - 12.2000
- Responsible for Patient Access Front desk and Preregistration department while actively participating and managing operations in the different department units such as Emergency Registrations, Insurance Verification, and Financial Counseling Units.
- Primary functions of the Financial Specialist I include performing insurance eligibility, authorization, and benefit verification, and providing administrative support.
- Collection of accurate demographic information, reviewing, and interpretation of insurance benefits and insurance liability.
Office Manager
Inland Orthopedics
Pomona
01.1996 - 12.1999
- Supervised and trained office personnel.
- Updated provider’s records and credentials.
- Processed payroll, federal, state taxes, and month end reports.
- Worked with general ledger postings, data entry, and accounts receivable/payable.
- Assisted front/back office with various tasks.
- Assisted doctor with minor surgical procedures in office, also taking complete history and physical on initial consultations, doctor’s first report, and pre-operative patients.
- Transcribed initial consultations, worker’s compensation evaluations, QME’s, and IME’s.
- Responsible for coding, billing, and collecting procedures performed in office, as well as hospital procedures.
- Submitting and obtaining request for authorizations for surgeries.
- Handled and arranged doctors schedule (surgeries, hospital stall meetings, and emergency on call schedules for three hospitals, court dates, and depositions).
Office Manager
Chino Hills Medical Group
Chino Hills
01.1994 - 12.1996
- Supported system transitions, monthly revenue reporting, staff onboarding, and patient benefit education.
- Standardized operations across the different office locations.
- Partnered with physician leadership to align clinical workflows with business goals.
- Developed strategic performance metrics to monitor and leading to measurable improvements in productivity and accountability.
- Implemented an enterprise authorization unit, streamlining processes and enhancing patient account management for improved operational efficiency.
Education
Basic Education -
Chino High School
Medical Terminology -
Chaffey Community College
Skills
- Revenue Cycle Management
- Business Office Management
- Staff Development
- Contract Management and Development
- Medicare/Medicaid Regulations/Compliance
- Capitation/HMO/Managed Care/Commercial Contract Management & Billing
- Patient Access
- Policy & Procedure Development
- Medical Coding/Utilization Review
- Denials Management
Accomplishments
- Key member of Patient Business Services Sr. Management Team
- Over the 16 years cash acceleration, and achieving organizational goals through innovative solutions, and best practices.
- EPIC Resolute Hospital Billing Implementation
- Ricoh Business Solution Implementation
References
Upon your Request.
Languages
Bilingual: English/Spanish
Timeline
Assistant Director
UCLA Health Systems
07.2008 - Current
Recovery Auditor, Denial Management Supervisor Patient Financial Services
Cedars Sinai Medical Center
02.2000 - 06.2008
Admitting Representative, Patient Financial Services
Pomona Valley Hospital Medical Center (Healthcare Financial Inc.)
01.2000 - 12.2000
Office Manager
Inland Orthopedics
01.1996 - 12.1999
Office Manager
Chino Hills Medical Group
01.1994 - 12.1996
Basic Education -
Chino High School
Medical Terminology -
Chaffey Community College