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Payer Enrollment's responsibility is to enroll providers into contracted and non-contracted (Medicaid) plans from department/division paper and electronic mail requests by completing paper applications. We research and request documentation, license, and certificates from departments/divisions that are required by more than 40 insurance payers and attach copies to the applications. We also research various error-reports and adjust as needed, verify information for insurance plans (Par/Non-Par, effective dates, provider specialties) and follow up with the payers when a response has not been received after an adequate timeframe regarding inaccurate information (i.e. incorrect effective date, specialty, etc.) In addition, we attend payer audits, and update and maintain physician records for additional locations, termination, provider numbers upon receipt and scanning documentation into the Vistar (VIP) System for electronic retrieval.
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