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Utilization coordinator skills for your resume and career

Updated January 8, 2025
3 min read
Quoted expert
Stuart Greenfield Ph.D.
Below we've compiled a list of the most critical utilization coordinator skills. We ranked the top skills for utilization coordinators based on the percentage of resumes they appeared on. For example, 16.6% of utilization coordinator resumes contained patients as a skill. Continue reading to find out what skills a utilization coordinator needs to be successful in the workplace.

15 utilization coordinator skills for your resume and career

1. Patients

Here's how utilization coordinators use patients:
  • Hold professional understanding of a caseload of patients' individualized treatment plans and clinical criteria through collaboration with treatment team.
  • Conducted comprehensive interviews of doctors, patients and providers to establish case histories and gather appeal-related documents and information.

2. Utilization Management

Here's how utilization coordinators use utilization management:
  • Coordinate pharmaceutical utilization management program.
  • Trained newly-hired Utilization Management Coordinators.

3. 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 utilization coordinators use patient care:
  • Reviewed medical care of inpatient hospitalizations and assisted in setting up outpatient care for both adult and pediatric population.
  • Participate in data collection aspects of quality review, and use the information to improve patient care and quality outcome.

4. Medical Terminology

Here's how utilization coordinators use medical terminology:
  • Maintained knowledge of medical terminology, anatomy and physiology, and medical coding and billing procedures utilizing proper insurance fee schedules.
  • Used knowledge of medical terminology to coordinate with physicians and ensure all abnormal conditions were assessed by consultation to specialty clinics.

5. 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 utilization coordinators use data entry:
  • Performed data entry authorization for Intake Coordinators and staff.
  • Reconciled accounts payable/receivable, including data entry.

6. 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 utilization coordinators use utilization review:
  • Prepared authorization requests for Medical Director and Utilization Review Nurse to include any medical documents and benefits pertinent to authorization request.
  • Improved utilization review activities to achieve a Sample Review Status from the Texas Medical Foundation/Peer Review Organization.

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7. Home Health

Here's how utilization coordinators use home health:
  • Work all phases of Home Health Referral process and provide new employee orientation and training.
  • Input all DME, Home Health and Infusion Episode requested by physicians or Vendors.

8. Discharge Planning

Here's how utilization coordinators use discharge planning:
  • Completed initial treatment plans and discharge planning for all consumers utilizing strengths based client centered approach.
  • Interacted and coordinated with physicians and Clinical team for discharge planning.

9. 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 utilization coordinators use mental health:
  • Collected clinical information from providers, analyzed, assessed, evaluated and authorized mental health and substance abuse treatment.
  • Provided authorization for inpatient medical and mental health admissions for fifteen Baltimore area hospitals.

10. Appeals

Here's how utilization coordinators use appeals:
  • Coordinated multiple administrative and operational support functions focused on appeals and subcommittee logistics.
  • Participate in training including maintenance of up-to-date materials with the UM Program Manager and Appeals & Grievances Specialists.

11. 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 utilization coordinators use cpt:
  • Assigned accurate ICD-9 and CPT codes to requested services for referral and authorization processing.
  • Complete notification along with ICD-9 and CPT coding.

12. Social Work

Here's how utilization coordinators use social work:
  • Provided school-based social work services, for children with developmental disabilities and their families to directly address academic performance and achievement.
  • Coordinated authorizations for hospital stays and durable medical equipment between insurance directors, hospital-based case management and social workers

13. Authorization Request

Here's how utilization coordinators use authorization request:
  • Process authorization requests for durable medical equipment by verifying insurance eligibility, determining medical necessity and gathering all required documentation.
  • Entered authorization requests for inpatient hospital stays as well as authorizations for skilled nursing facilities and transportation as needed.

14. Autocad

Here's how utilization coordinators use autocad:
  • Prepare Civil drawings using AutoCAD.
  • Used Microstation and Autocad to create drawings.

15. ICD-9

Here's how utilization coordinators use icd-9:
  • Leveraged excellent skills in ICD-9 and CPT-4 coding to submit healthcare claims and ensure efficient processing of reimbursements.
  • Entered ICD-9 codes, obtained authorizations from care homes for retreatment for discharged Patient.
top-skills

What skills help Utilization Coordinators find jobs?

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

What soft skills should all utilization coordinators possess?

Stuart Greenfield Ph.D.Stuart Greenfield Ph.D. LinkedIn profile

Professor, Austin Community College

Given the changing demographics that the country has experienced, the entire education continuum must change. According to the Brookings Institution, Brookings, the non-Hispanic White population in the under 18 cohort since 2000 has declined.

As you'll note from the occupations that are projected to increase the greatest, most require face-to-face contact, so that soft-skills will be necessary. I would also expect that critical thinking skills will be needed as more responsibility will be required of front-line workers.
Do you want to know more?
Read more about what experts have to say about utilization coordinator

List of utilization coordinator skills to add to your resume

Utilization coordinator skills

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

  • Patients
  • Utilization Management
  • Patient Care
  • Medical Terminology
  • Data Entry
  • Utilization Review
  • Home Health
  • Discharge Planning
  • Mental Health
  • Appeals
  • CPT
  • Social Work
  • Authorization Request
  • Autocad
  • ICD-9
  • InterQual
  • CMS
  • Concurrent Review
  • Medicaid
  • Health Plan
  • HMO
  • Medical Management
  • Medical Necessity Review
  • Milliman
  • Outpatient Services
  • ICD-10
  • IPA
  • Outbound Calls
  • Inbound Calls
  • Clinical Review
  • Durable Medical Equipment
  • CCS
  • Insurance Eligibility
  • PHI
  • Medical Services
  • Medi-Cal
  • Eating Disorders
  • Hippa
  • Inpatient Admissions
  • Denial Letters
  • MDS
  • Utility Bills
  • Medical Directors
  • Utility Accounts
  • Utility Services
  • Authorization Processing
  • Member Eligibility

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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