Defining revenue integrity skills

Friday, June 7, 2024

2024 Revenue Integrity Week is an opportunity to celebrate the skills and accomplishments of revenue integrity professionals. Through resources, education, and programs such as the Certification in Healthcare Revenue Integrity (CHRI) credential, NAHRI supports the revenue integrity field and the growth of revenue integrity professionals by helping to identify and define key revenue integrity skills and competencies.

NAHRI asked members of the 2024 Networking and Events Committee to explain what they believe are some of the key skills a revenue integrity professional should have. Here’s what they told us.

Q: What are some of the key skills or qualities a revenue integrity professional should have?

Kelly Bowley, RN, MBA, CRCE, senior director of healthcare business transformation, revenue cycle, FTI Consulting, Washington, D.C.: There are a few key skills or qualities that will position someone for success in the field. Those skills include the ability to apply critical thinking and problem solve, having an attention to detail, a strong work ethic and ethical conduct, adaptability and being able to collaborate with others, and willingness to continually learn.

Sandy Giangreco Brown, MHA, BS, CHRI, RHIT, CCS, CCS-P, CHC, CPC, COC, CPC-I, COBGC, PCS, director of coding and revenue integrity, CliftonLarsonAllen, LLP, Broomfield, Colorado: Many of the main skills or qualities that revenue integrity professionals should have are being detail oriented, problem solvers, hard-working, and eager and wanting to learn! It is also critical to be able to research and find resources and answers to questions that folks will have, and there will be many!

Jennifer Gardiner, senior director of revenue integrity, University of Maryland Medical Center, Baltimore, Maryland: Curiosity is a key skill. Additionally, a revenue integrity professional should be organized and possess critical thinking skills. They also must be collaborative and flexible in how they approach working with multiple teams.

Lisa Kanivetsky, CPC, CHRI, revenue integrity advisor, University Hospital, Newark, New Jersey: Clinical experience, IT, coding, management, and perseverance.

Daphne Pell, RHIA, CHRI, vice president, Claro Healthcare, Chicago, Illinois: Revenue integrity professionals need to have a high level of integrity, be comfortable with ambiguity, flexible and open to change, curious about root causes, have an investigative mindset, and be a team player.

Mia Reddick-Smith, MBA, PMP, AVP, revenue integrity, Lifepoint Health, Brentwood, Tennessee: Key skills should include someone with knowledge of Current Procedural Terminology (CPT©) and Healthcare Common Procedure Coding System (HCPCS) coding and understanding regulatory guidance or how to research the guidance. Other important skills include knowledge of revenue code and their impact on CPT/HCPCS codes, and claims resolution. A revenue integrity professional has to be a critical thinker and know how to interpret guidelines and their impact on operations.

Tina Rosier, MS, PT, director of revenue integrity at Community Health Network. Indianapolis, Indiana: Clinical/medical terminology experience, coding knowledge, being detail oriented, and having the desire and capacity to learn something new every day!

Stacie Smith, senior manager, Windham Brannon, Atlanta, Georgia: A revenue integrity professional should have a coding/billing background; understanding of healthcare regulations; ability to analyze and solve challenging problems; ability to communicate to leaders, payers, and provides; and strong attention to detail.

Diane Weiss, CPC, CPB, CHRI, vice president of revenue integrity and education, RestorixHealth: Revenue integrity professionals should be curious and comfortable asking questions, but in the most professional and supportive way possible. Revenue integrity professionals should adopt and provide a supportive approach and not initially take a punitive approach.

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Revenue Integrity