Contract Configuration Specialist - San Antonio, TX

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

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Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

Let's talk about meaningful work, an important role and a career move that can transform your future. WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. At WellMed, now part of Optum and the UnitedHealth Group family of businesses, we focus on prevention and the complete coordination of care for our patients. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth. Join us and you'll be part of a team dedicated to patient-centered, safe and effective health care. Your skills and talents will make an important impact on our patients while you open doors for yourself that simply do not exist in any other organization.

Times are exciting here as we continue to grow and expand our markets. We are now seeking a Contract Configuration Specialist at our location in San Antonio, TX.

Primary Responsibilities:
  • Manages and configures contract reimbursement methodologies within specified timeframes into claims payment system
  • Tests and audits claims payment accuracy against contact information loaded into claims payment system
  • Completes assigned claims in provider set up queue timely and accurately
  • Assists with responding to email inquiries received on a daily basis
  • Assists with reviewing/researching provider disputes due to contact set up issues
  • Partners with other departments to ensure appropriate data is collected and maintained
  • Interprets and configures contract terms and claims coding in a risk based environment
  • Understands health insurance benefit administration in a risk based environment
  • Utilizes data in the development and implementation of managed care strategies
  • Acts as a resource to other internal departments on contract issues
  • Expected to meet or exceed departmental timeframes and quality metrics on a consistent basis
  • Takes ownership of the work process, seeks ways to improve job and process efficiency and makes appropriate suggestions and solutions to management

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
  • High school diploma or GED
  • 2+ years of health care claims processing experience
  • Familiar with medical terminology
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:
  • Exceptional ability to organize, prioritize, multi-task and communicate effectively
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Contract Configuration Specialist, Contract Specialist, Configuration Specialist, San Antonio, TX, Texas

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