Lisa Phillips
Kalispell,MT
Overview
24
24
years of professional experience
Work History
Medical Staff Credentialing Specialist
Logan Health Medical Center
Kalispell, MT
01.2016 - 10.2023
- Reviewed and processed credentialing applications for 300+ medical providers annually to ensure accuracy, completeness and compliance with appropriate accreditation standards.
- Quality information reports and summary to accompany reappointments.
- Interacted regularly with providers regarding credentialing matters.
- Conferred with management in researching and resolving discrepancies between submitted provider data and verified sources.
- Provided support in responding to inquiries from internal and external parties regarding credentialing and medical staff services information.
- Coordinated medical staff meetings, completed minutes and follow-up in a timely fashion.
- Participated actively in special projects or initiatives pertaining to process improvement of operational efficiency within the department.
Medical Staff Coordinator
North Valley Hospital (now part of Logan Health)
Whitefish, MT
01.2014 - 01.2016
- Same job description as noted above.
Credentialing & HR Coordinator
Santa Rosa Community Health Centers
Santa Rosa, CA
06.2010 - 12.2013
- Responsible for setting up the credentialing program and processing credentialing applications to ensure accuracy and completion per accreditation standards.
- Conferred with management and aided the accreditation committee in preparation for securing JCAHO accreditation. Primary responsibility was to create the credentialing and privileging policies and procedures, and to ensure that our credentialing and privileging process was inline with JCAHO standards. Our organization passed the accreditation audit, with no dings regarding our credentialing program.
Senior Credentialing Specialist
Sutter Health
Santa Rosa, CA
01.2000 - 06.2010
Senior Credentialing Specialist
Sutter Health
Santa Rosa, CA
01.2000 - 06.2010
- Reviewed and processed all credentialing applications for medical providers to ensure accuracy, completeness and compliance with NCQA standards.
- Completed quality information reports and summaries to accompany all completed applications.
- Interacted regularly with representatives from health plans and commercial payers regarding credentialing, enrollment and health plan audits.
- Completed provider enrollments into Medicaid, Medicare and insurance plans.
- Provided support in responding to inquiries from internal and external parties regarding credentialing and managed care services information.
- Coordinated Credentialing Committee meetings, completed minutes and follow-up in a timely fashion.
- Participated actively in special projects or initiatives pertaining to process improvement of operational efficiency within the department.
Education
Legal Clerical Certificate - Legal And Administration
Empire College
Santa Rosa, CA04-1991
Skills
Certified Provider Credentialing Specialist since 11/2008
Excellent in internal and external communications
Timeline
Medical Staff Credentialing Specialist
Logan Health Medical Center
01.2016 - 10.2023
Medical Staff Coordinator
North Valley Hospital (now part of Logan Health)
01.2014 - 01.2016
Credentialing & HR Coordinator
Santa Rosa Community Health Centers
06.2010 - 12.2013
Senior Credentialing Specialist
Sutter Health
01.2000 - 06.2010
Senior Credentialing Specialist
Sutter Health
01.2000 - 06.2010
Legal Clerical Certificate - Legal And Administration
Empire College