How Can I Become a Managed Care Coordinator?

Managed care coordinators work with medical facilities and health insurance companies to ensure medical services are authorized and that regulatory guidelines are followed. Learn what it takes to work in this field. Schools offering Health Care Administration degrees can also be found in these popular choices.

What is a Managed Care Coordinator?

As a managed care coordinator, you will handle a variety of operational issues needed to ensure the smooth communication between a medical facility, the insurance companies the facility participates with, and the patients. While reporting to upper management, you will primarily be responsible for authorizing services, handling insurance claims, overseeing patient billing and ensuring that Medicare and Medicaid guidelines are followed. You may also be asked to maintain financial and patient records and determine what services are available.

Pursue the Education and Training That Fits

Before choosing a program, you'll want to explore your options as well as the regulations for the state where you'd like to work. If you'd like to work in a specific type of facility, it's even more important you choose the right program.

Based on job listings posted in August 2012, education qualifications for a managed care coordinator can vary from simply a high school diploma combined with work experience to a master's degree. However, it is most common in this field for professionals to have a bachelor's degree in a major such as health services administration or public health. Coursework in a health services administration program may include topics such as accounting, budgeting, health information systems, hospital organization and strategic planning. A public health major may include study in general biology, health economics, human rights and health, health and environment, and health psychology.

Registered nurse (RN) certification is also often required, along with approximately 2-4 years of work experience. Working in certain specialized medical care fields, such as mental health or substance abuse, may require having a master's degree. A master's degree program typically consists of 2-3 years of study. A year of supervised experience is also generally part of the program.

Understand the Job Options

As indicated by August 2012 job listings, possible work settings for this position can range from doctor's offices, hospitals and other medical facilities to assisted living facilities, mental health units, community health centers and insurance firms. In general, the skills you need include a strong background in related medical terminology, medical coding, third-party payment systems and managed care principles. Other skills include the ability to work independently, communicate effectively and act as a liaison with relevant personnel.

Gain Experience in the Healthcare Field

Many college programs provide internships and service learning opportunities. You may want to find out if your school has campus events or relevant outreach programs. Activities like these may help you fulfill experience requirements as well as provide you with networking and other opportunities.

To continue researching, browse degree options below for course curriculum, prerequisites and financial aid information. Or, learn more about the subject by reading the related articles below:

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