Post job

Explore jobs

Find specific jobs

Explore careers

Explore professions

Best companies

Explore companies

OverviewJobsSalaryResume

Skills

What They DoEducationDemographicsJob DescriptionHow To HireBest CompaniesBest StatesBest CitiesRemote JobsJob OutlookCompareEntry Level jobsFull Time jobsWork From Home jobs
zippia ai icon

Automatically apply for jobs with Zippia

Upload your resume to get started.

Claims coordinator skills for your resume and career

Updated January 8, 2025
6 min read
Claims coordinator example skills
Below we've compiled a list of the most critical claims coordinator skills. We ranked the top skills for claims coordinators based on the percentage of resumes they appeared on. For example, 23.0% of claims coordinator resumes contained customer service as a skill. Continue reading to find out what skills a claims coordinator needs to be successful in the workplace.

15 claims coordinator skills for your resume and career

1. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how claims coordinators use customer service:
  • Provide exemplary customer service to customers ranging from large corporate clients to independent owner- operators.
  • Provided customer service assistance to Insureds, Consultants and attorneys regarding status of insurance.

2. Patients

Here's how claims coordinators use patients:
  • Ensured accuracy of claims and corresponded with insurance representatives and patients to receive on-time payment.
  • Established payment arrangements on patient accounts, verified the patients benefits and eligibility.

3. Data Entry

Data entry means entering data into a company's system with the help of a keyboard. A person responsible for entering data may also be asked to verify the authenticity of the data being entered. A person doing data entry must pay great attention to tiny details.

Here's how claims coordinators use data entry:
  • Negotiated budget payment plans/settlements within department guidelines, medical data entry and updated payments in the computer system.
  • Supported department with filing, data entry and other clerical responsibilities.

4. Phone Calls

Phone calls are a wireless or wired connection made over a telephone or a mobile phone between two people. Two parties are involved in a phone call, the caller and the receiver. A caller dials the number of the one he wants to call, and the recipient hears a bell or a tune to which he picks up the call. The call establishes a connection between them through which they can communicate. The voice is converted into signals and is transmitted through wired or wireless technology.

Here's how claims coordinators use phone calls:
  • Provide support for Management to adhere departmental guidelines regarding timeliness in returning phone calls/email, productivity, and accuracy in claims.
  • Answer any incoming phone calls regarding claims handling and forward the call to the appropriate handling adjuster.

5. Insurance Claims

Here's how claims coordinators use insurance claims:
  • Handled all aspects of processing automotive insurance claims including investigation, liability determination and claims coverage issues.
  • Reviewed incoming domestic and international insurance claims forms to determine proper coverage and process claim upon verified.

6. Quality Standards

Quality standards are a specific level of standards of products that are set by the companies for the customers that have to be met and maintained throughout the process until the time of delivery. Quality standards are information that includes the customer's requirements, guidelines, and characteristics for the needed final product or service.

Here's how claims coordinators use quality standards:
  • Developed, implemented and maintained training materials ensuring production and quality standards were met.
  • Developed and implemented National Quality Standards program, which included performing 10 to 12 field office performance audits per year.

Choose from 10+ customizable claims coordinator resume templates

Build a professional claims coordinator resume in minutes. Our AI resume writing assistant will guide you through every step of the process, and you can choose from 10+ resume templates to create your claims coordinator resume.

7. Medicaid

Here's how claims coordinators use medicaid:
  • Provided guidance to Medicaid members and providers on the policies and procedures according to state/federal guidelines.
  • Coordinated provider and Medicaid plans claim activity which included processing/investigating claims for payment or denial.

8. CPT

CPT is a medical term that stands for Current Procedural Terminology. Whenever a procedure like surgery or diagnosis occurs or some other medical service is rendered to a patient, it is reported to the concerned physician, insurance company, or organization. The aforementioned practice is widely referred to as CPT.

Here's how claims coordinators use cpt:
  • Review and audit claims -Using correct CPT and DX codes -Denial reports -Corrected billing error, resubmitted claims for proper payment
  • Trained Claims Representative Staff on the basics of CPT, HCPC, ICD-9 coding

9. CMS

A Content Management System or CMS is computer software that works as a framework where content can be assembled and managed by using a database. CMS is an important asset in web development. This platform enables users to create, edit, collaborate on, publish and store digital content. It helps users to manage their content and modify it from a single system.

Here's how claims coordinators use cms:
  • Evaluated and audited performance levels, utilizing CMS Software.
  • Manage Medicare billing for 80 Skilled Nursing Facilities nationwide Analyze facility requests and advises facilities regarding Medicare billing and CMS regulations.

10. Medical Claims

Here's how claims coordinators use medical claims:
  • Assisted medical claims staff by interpreting provider contracts, processing guideline and authorizations.
  • Created and implemented procedures to automate medical claims research process.

11. Appeals

Here's how claims coordinators use appeals:
  • Executed effective and efficient claim dispute resolutions in regard to provider and facility appeals.
  • Provided support to interdepartmental staff related to resource allocation and budget appeals.

12. Medical Necessity

Here's how claims coordinators use medical necessity:
  • Process Medicare denials for medical necessity and monitor clients for trends.
  • Review eligibility of equipment depending upon certificate of medical necessity (CMN) forms requested from physician.

13. Claims Handling

Here's how claims coordinators use claims handling:
  • Negotiated fair compensation settlements within authority while remaining in compliance with state insurance regulations including fair claims handling practices.
  • Managed 3rd party administrator to ensure claims handling for 140 stores covering 6 state area was in accordance with special instructions.

14. Process Claims

Process claims refers to the procedure an insurance agent follows once receiving a claim from an insured individual. This often includes reviewing, investigating, and deciding on whether the claim will be accepted or denied depending on the results of the insurer's investigation. This is a common procedure for all kinds of insurance including medical, auto, and liability insurance.

Here's how claims coordinators use process claims:
  • Direct outside vendor how to process claims, how to apply fee schedules, and policies and procedures for correct reimbursement.
  • Informed disability members of documentation required to process claims, required time frames, payment information and claims status.

15. Insurance Adjusters

Here's how claims coordinators use insurance adjusters:
  • Interacted with insurance adjusters through outbound and inbound telephonic contact to review and assess claims and Medicare eligibility.
  • Collaborated with Insurance Adjusters and Attorneys to obtain documentation to complete medical records.
top-skills

What skills help Claims Coordinators find jobs?

Tell us what job you are looking for, we’ll show you what skills employers want.

List of claims coordinator skills to add to your resume

The most important skills for a claims coordinator resume and required skills for a claims coordinator to have include:

  • Customer Service
  • Patients
  • Data Entry
  • Phone Calls
  • Insurance Claims
  • Quality Standards
  • Medicaid
  • CPT
  • CMS
  • Medical Claims
  • Appeals
  • Medical Necessity
  • Claims Handling
  • Process Claims
  • Insurance Adjusters
  • Litigation
  • Claims Management
  • ICD-9
  • Management System
  • Insurance Carriers
  • TPA
  • HIPAA
  • Computer System
  • Customer Claims
  • Insurance Coverage
  • Outbound Calls
  • Customer Complaints
  • Freight Claims
  • Policy Holders
  • Defense Counsel
  • Police Reports
  • Workers Compensation Claims
  • FMLA
  • External Parties
  • A/R
  • EOB
  • Warranty Claims
  • Claims System
  • Subpoenas
  • Claims Issues
  • Pending Claims
  • Patient Accounts
  • Hippa
  • Liability Claims
  • PowerPoint
  • Unpaid Claims
  • Property Damage Claims
  • HMO
  • Electronic Claims

Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

Browse business and financial jobs