My revenue integrity journey
by Lisa Longo, CPC, CPC-I, CSMC, CHRI
So how did I find the path to revenue integrity? I was just married, and I began my “big girl” job at a local hospital in Connecticut. I stayed employed at this hospital for many years and I am grateful for every opportunity they gave me. I started as a Medicare biller and then floated through most of the roles in the billing department, including cash posting, insurance follow-up, and credit and collection. I was very lucky to move my way up through the ranks without a formal degree. I held various leadership roles in patient accounting throughout the years and was the first revenue integrity manager at the hospital. One of my favorite roles during my tenure there was the chargemaster. It was something totally out of my expertise. I had strong knowledge in government billing and regulations, but not on how the chargemaster actually worked. I found that I enjoyed looking for charges, assisting with denial turnover, and working with the clinical areas. I also received my CPC certification while in that position. Through dedication, research, and a bit of training by consultants who performed our external reviews and audits, I became very well-versed in the chargemaster area, and it actually became the role in revenue integrity I favored the most.
Well, you know the saying, being at the right place at the right time, and that happened for me after 30 years with the same facility. At a year-end educational session, I ran into a connection I knew who put a bug in my ear about a chargemaster job that would encompass some managed care work at another Connecticut hospital. This intrigued me, as managed care was out of my element. After much thought, I chose to leave my job at the time to take that position. It turned out the timing was right due to impending changes at my previous facility. There were also some personal issues that made a management role difficult due to the amount of time needed to dedicate to managing the workload and staff. I have to say my new employer has been very accommodating and the role has been a great change. I get to concentrate on those areas that were most fulfilling, while learning some other aspects of hospital finance.
Let me say, I am not one who likes the structure of school, but I like to learn. Certifications have helped me expand my knowledge. I enjoy that opportunity to concentrate on a specific area. I do not hold a degree (I am an active college student), but I have been lucky to find success in healthcare revenue cycle/finance without it. So today, I am in a role that I love. I hold certifications in coding and managed care. I am also proud to have taken part in the exam preparation for the CHRI credential and excited to be one of the first to receive that credential this year. These credentials, I believe, have allowed me to grow without having that college degree. I do think an actual degree would be an asset, but I have done well without it. For now, I look forward to learning and growing in revenue integrity and maybe, just maybe, I will finish that degree.