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Managed care coordinator skills for your resume and career

Updated January 8, 2025
4 min read
Quoted experts
Linda Galocy,
Linda Galocy
Managed care coordinator example skills
Below we've compiled a list of the most critical managed care coordinator skills. We ranked the top skills for managed care coordinators based on the percentage of resumes they appeared on. For example, 17.3% of managed care coordinator resumes contained patients as a skill. Continue reading to find out what skills a managed care coordinator needs to be successful in the workplace.

15 managed care coordinator skills for your resume and career

1. Patients

Here's how managed care coordinators use patients:
  • Organized the multidisciplinary discharge process for an assigned patient population Provided education to patients with regards to specific disease processes
  • Collaborated with clinical staff and clinical supervisors on insurance authorization issues to ensure patients received appropriate services.

2. Social Work

Here's how managed care coordinators use social work:
  • Collaborated extensively with social workers, physicians and other specialists to facilitate care processes and ensure comprehensive accuracy among all documentation.
  • Supervised two college-age social work interns by providing weekly clinical supervision.

3. Home Health

Here's how managed care coordinators use home health:
  • Facilitated and coordinated authorizations for Home Health Care visits.
  • Obtain authorization/re-authorization for home health services.

4. 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 managed care coordinators use customer service:
  • Recognized by management for excellent performance regarding TAT, superior customer service, and accountability with providers.
  • Utilize medical and insurance coding techniques to correctly process insurance claims and provide excellent customer service.

5. Discharge Planning

Here's how managed care coordinators use discharge planning:
  • Coordinated member's admission and rehabilitation and discharge planning procedures and transportation and interpretation services.
  • Performed discharge planning and provided referrals for aftercare treatment.

6. Patient Care

Patient care entails the diagnosis, recovery, and control of sickness as well as the maintenance of physical and emotional well-being through the use of healthcare providers' services. Patient care is described as services provided to patients by health practitioners or non-professionals under guidance.

Here's how managed care coordinators use patient care:
  • Promote quality, cost effective patient care by providing the interdisciplinary team all information necessary to positively influence optimal patient outcomes.
  • Established a collaborative relationship with physicians, nurses and discharge planners, resulting an improved communications and enhanced patient care.

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7. Medical Terminology

Here's how managed care coordinators use medical terminology:
  • Translated medical terminology; English/Spanish between migrant workers and physicians.
  • Used medical terminology and codes to set up cases for members medical procedures via both phone and fax requests.

8. Medicaid

Here's how managed care coordinators use medicaid:
  • Ensured all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies.
  • Maintained current database of information regarding managed care, Medicare and Medicaid contracts.

9. Community Resources

Community resources are a set of resources that are used in the day to day life of people which improves their lifestyle in some way. People, sites or houses, and population assistance can come under the services offered by community resources.

Here's how managed care coordinators use community resources:
  • Served as a liaison and problem solver for non-clinical issues/concerns to effectively utilize community resources and member needs.
  • Demonstrated broad knowledge of area community resources/agencies.

10. Mental Health

Mental health is the state of wellbeing in which an individual can cope with the regular stresses and tensions of life, and can work productively without having any emotional or psychological breakdown. Mental health is essential for a person of any age and helps them make the right decisions in their life.

Here's how managed care coordinators use mental health:
  • Collaborated with multidisciplinary medical team to coordinate mental health care management services.
  • Provide consultation services to non-profit ministries regarding mental health topics.

11. Rehabilitation

Here's how managed care coordinators use rehabilitation:
  • Enter and approve authorizations for patients being discharged from hospitals to a sub- acute rehabilitation facility or a skilled nursing facility.
  • Liaised with up to 20 specialists to determine key opportunities to facilitate patient transitions to rehabilitation and retirement communities.

12. Utilization Review

Another name for utilization review is utilization management. It is the process of ensuring that healthcare services are used in a suitable manner. Utilization review is a critical component of adding value to the health care system. Mostly, UR is carried out by healthcare insurance companies, but hospitals and other healthcare providers also perform the process. Utilization review has three types of assessment namely: concurrent, prospective, and retrospective.

Here's how managed care coordinators use utilization review:
  • Facilitated authorization processes with utilization review
  • Project accomplishments included researching and selecting cost effective utilization review systems, creating and writing guidelines, protocols and information manual.

13. 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 managed care coordinators use data entry:
  • Executed data entry of authorizations and medical notes.
  • Perform data entry of all requests and utilize the appropriate protocols and code identifiers as required internally and by the client.

14. Good Judgment

Here's how managed care coordinators use good judgment:
  • Provided emotional and physical support to persons with disabilities along with demonstrating good judgment in decision-making and problem-solving.
  • Used good judgment when dealing with payers, providers, and patients.

15. 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 managed care coordinators use cpt:
  • Assign ICD-9 to physicians' diagnosis and insure correct level of service and various other CPT codes.
  • Walked through the reconciliation process with the provider on claims (ICD-9 and CPT codes).
top-skills

What skills help Managed Care Coordinators find jobs?

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

What skills stand out on managed care coordinator resumes?

Linda Galocy

Director and Assistant Dean, Clinical Associate Professor, Indiana University Northwest

Revenue Cycle Management, Data Analytics, Information Governance, Privacy and Security of health information.

What soft skills should all managed care coordinators possess?

Linda Galocy

Director and Assistant Dean, Clinical Associate Professor, Indiana University Northwest

Writing skills, communication, organization, the ability to multi-task, critical thinking skills.

What hard/technical skills are most important for managed care coordinators?

Linda Galocy

Director and Assistant Dean, Clinical Associate Professor, Indiana University Northwest

Technical skills are dependent on the job, but working with multiple types of software at one time is very common in the health information profession. Patient records are electronic. Therefore, the ability to learn and adapt to electronic health record systems is a must. In addition, supportive software is typically used in order to get the work done, such as an encoder, which allows a medical coder to assign codes to a patient record, a release of information system that is utilized for tracking requests for patient records from the time the request is received until it is complete. The ability for
+a health information professional to understand an entire process, such as the revenue cycle. There are many individuals involved in the process of obtaining payment for healthcare services rendered, and it is important for everyone to do their job, do it correctly, and when errors occur, work together to correct those errors.

What managed care coordinator skills would you recommend for someone trying to advance their career?

Forrest Kuiper

Fire Chief, University of Alaska Fairbanks

In addition to academic education, experiential learning is a critical part of emergency services. The more experience you can gain, the better suited you are to being successful. In the next 3-5 years, leading with technology and innovation will lead to emergency services being more efficient and effective. Emergency services have always been all-hazard, but knowing the needs of your community will help you understand what they need.
Do you want to know more?
Read more about what experts have to say about managed care coordinator

List of managed care coordinator skills to add to your resume

Managed care coordinator skills

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

  • Patients
  • Social Work
  • Home Health
  • Customer Service
  • Discharge Planning
  • Patient Care
  • Medical Terminology
  • Medicaid
  • Community Resources
  • Mental Health
  • Rehabilitation
  • Utilization Review
  • Data Entry
  • Good Judgment
  • CPT
  • Medical Necessity
  • Disease Management
  • Insurance Eligibility
  • HIPAA
  • Medical Services
  • NCQA
  • Clinical Review
  • Durable Medical Equipment
  • Care Contracts
  • MCO
  • ICD-9
  • Patient Accounts
  • Insurance Verification
  • Physical Therapy
  • HEDIS
  • Insurance Coverage
  • Relevant Tasks
  • Insurance Benefits
  • Fee Schedules
  • Utilization Management Functions
  • Hippa
  • HMO
  • Insurance Carriers
  • CMS
  • Referral Process
  • Clinical Operations
  • Care Organizations
  • SNF
  • IDX

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

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