New year, new professional goals

The new year is upon us: a time to reflect on what we accomplished in the past 12 months and make resolutions for a better year ahead. More often than not, we make resolutions that impact our personal lives—get to the gym, eat better, save more money. Nothing wrong with that. But what about our professional resolutions? We spend at least 40 hours each week at our jobs, so why not focus on resolutions that help us do our best during those hours?

Here’s my New Year’s challenge for you: Resolve to improve your professional standing while furthering the revenue integrity profession by earning your Certification in Healthcare Revenue Integrity (CHRI) credential.

The CHRI credential provides a trusted baseline of competency for healthcare revenue integrity professionals. Studying for and passing the credential exam will help you brush up on your revenue integrity skills and prove your value to your organization. “I believe the CHRI exam proves the person’s breadth and depth of knowledge,” says CHRI Credential Committee member Julie Leonard, CPC, CCS, CPCO, CRCR, ACS-AN, RCC, associate director at Kohler HealthCare Consulting, Inc., in Woodstock, Maryland. “This is not a beginner’s exam.”

Candidates who apply for the examination must meet one of the following sets of requirements:

1. One or more years of experience in healthcare revenue cycle, coding, compliance, or revenue integrity and a bachelor’s degree OR
2. Two or more years of experience in healthcare revenue cycle, coding, compliance, or revenue integrity and an associate’s degree OR
3. Three or more years of experience in healthcare revenue cycle, coding, compliance, or revenue integrity in the absence of a degree

“I believe that the CHRI credential is long overdue and will assist in recognizing the body of knowledge that the revenue integrity professionals have long held,” says CHRI Credential Committee member Elaine O’Bleness, MBA, RHIA, CDIP, CHP, CRCR, revenue cycle client value executive for Cerner Corporation in North Kansas City, Missouri. “Participating in the committee and writing the examination has been a very professionally rewarding experience for me.”

The CHRI credential can help new and veteran revenue integrity professionals demonstrate knowledge of revenue integrity core competencies. Professionals who hold the CHRI have proven their proficiency in rules and regulations, compliance, revenue management, and internal reporting strategies.

“I believe in credentialing and that having your CHRI will benefit the individual and their career as well as the revenue integrity profession,” says CHRI Credential Committee member Rayleen M. Kelly, RN, CCDS, CIC, CRC, medical documentation internal pool coordinator at Mercy in St. Louis.

Revenue integrity professionals play an integral role in the financial health of their organizations. As this field grows, it is critical to ensure they have a means of demonstrating their competency in core skills relevant to their roles. The mission of the CHRI credential is to ensure healthcare revenue integrity professionals are recognized for their due diligence in the field and their dedication to professional growth.

“This has been a great experience for me. I’ve enjoyed working with such a great group of professionals.  I think having this credential is a step forward for the revenue integrity specialist,” says CHRI Credential Committee member Becky Moore, MSA, director of charge compliance at Beaumont Health in Southfield, Michigan. “It defines and validates the knowledge we have and offers well-deserved recognition for this profession.”

The objectives of the CHRI program are as follows:

• Recognize the valuable contributions and knowledge base of healthcare revenue integrity professionals who have proven competency in revenue integrity subject matter through successful completion of the certification process
• Promote knowledge of core skills relevant to the revenue integrity field, including mastery of relevant rules and regulations; ability to perform root cause analysis; aptitude for managing denials and appeals; knowledge of monitoring and auditing practices; assurance of accuracy of chargemaster pricing structures and codes; understanding of coding, documentation, and billing requirements; and ability to develop internal reporting strategies that identify trends and solve problems
• Assist healthcare facilities in ensuring staff have the knowledge and experience to perform essential revenue-related job functions and bring value to the organization

“CHRI certification benefits employers and revenue integrity professionals by promoting career development and recognition for individuals,” says CHRI Credential Committee member Debbie Nash, MBA, AVP of revenue capture support at Atrium Health in Charlotte, North Carolina. “This will allow another method to document an individual’s experience, knowledge, and education within the growing field of revenue integrity. Obtaining CHRI certification will allow others in the industry to know your commitment to your profession, quality, and ethics.”

The CHRI credential offers revenue integrity professionals the opportunity to hone and validate their knowledge base while ensuring facilities have a benchmark by which to measure the competency of their staff and to recruit team members who are committed to bringing value to the industry and staying abreast of changes in regulations and best practices. “The CHRI certification is extremely important to revenue integrity as it sets a higher standard for our discipline as well and sets those apart in the industry who successfully receive the certification,” says CHRI Credential Committee member Angela A. Musey, RN, MBA, MACC, interim director of revenue integrity at Gwinnett Medical Center in Lawrenceville, Georgia.

Exam content and preparation

The CHRI exam is made up of four parts:

1. Education (25%)
2. Compliance (25%)
3. Revenue (25%)
4. Reporting (25%)

“I can tell you, coming from the professional side of healthcare, this exam is not for the faint at heart. This exam requires the participant to have a very broad and well-rounded knowledge of the healthcare revenue cycle that truly can only come from experience,” says Leonard. “There are exams for coding and billing and revenue cycle that are available from other organizations. NAHRI has the only exam that takes all aspects of revenue cycle management and brings them all together for a comprehensive revenue integrity exam, bridging all those gaps into a cohesive body of knowledge.”

Early adopters of the CHRI credential are encouraged to refer to our full exam outline to ensure they are prepared for the exam. A comprehensive study guide is forthcoming. In the meantime, if you are looking for the latest in revenue integrity education, NAHRI recommends the following resources. While not specifically developed for CHRI exam study, they can prove helpful in staying up to date on content relevant to the revenue integrity profession:

• Revenue Integrity and Chargemaster Boot Camp (NAHRI members save $150)
• Revenue Integrity Essential Skills Online Learning
• Core Functions of Revenue Integrity
• The Revenue Integrity Manager's Guidebook
• The Chargemaster Essentials Toolkit
• Medicare Billing Edits: Solving NCCI and MUEs

The fee for the certification application process and examination is $255 for NAHRI members and $355 for non-members. NAHRI members can also save on some of our recommended resources through standard NAHRI member discounts and through our quarterly discounts in the NAHRI Journal.

“I think having this credential will be a great asset for someone who is really looking at broadening their career outside of PFS, nursing, compliance, coding, or auditing,” says NAHRI Advisory Board and CHRI Credential Committee member Lisa Longo, CPC, CPC-I, senior managed care revenue cycle analyst at Middlesex Hospital in Middletown, Connecticut. “This credential will help tie pieces of these roles into one to ensure all revenue is being captured and being captured compliantly, and it will also provide guidance on tools for monitoring.”

A word from the credential committee

The CHRI credential has been in the works for the last year or so. Creating an exam that tests the full breadth of revenue integrity professionals’ skills has been no small task, but with the help of our dedicated Credential Committee, it has been a rewarding and exciting journey. The Committee put in long hours developing the CHRI exam outline and content, prerequisites, and recertification requirements to ensure everything met acceptable industry standards and was properly vetted.

“Working on the CHRI Credential Committee has been a great experience for me personally,” says Kelly. “After taking other credential tests for my job, I have wondered about the test process and what it involved. Like most things, there is a distinctive process involved in putting together a test for credentialing. The NAHRI members on the CHRI Credential Committee are both very knowledgeable and fun to work with!” 

Providing a comprehensive credential for revenue integrity professionals is a tremendous responsibility. When we embarked on this journey, I was excited for what this credential would mean for the association, the industry, and each revenue integrity professional who would sit for the exam. What I didn’t anticipate was the bonds that would form through the committee. I feel so much more connected to NAHRI members and the revenue integrity profession after working with such an intelligent and dedicated group of professionals.

“The whole process of developing the exam has been truly an educational and enlightening experience,” says Longo. “Developing the questions was the most difficult part. Each of us had some very different strengths that I think gave us a pretty comprehensive exam at this point.”

“Good enough” was not an option for this committee. They toiled away at drafting questions, rewriting content, and testing the validity of the exam time and again—jumping on each development call with as much energy and enthusiasm as the last. Getting to know these professionals and seeing how hard they work has been a reward in itself—and launching the exam is the icing on the cake.

“I am very excited that NAHRI has worked on a credential for revenue integrity professionals,” says CHRI Credential Committee member Kim Yelton, RHIA, CCS, CDIP, director of revenue integrity at WakeMed Health and Hospitals in Raleigh, North Carolina. “This credential will allow folks to show their expertise in this steadily growing field. In helping with the exam, it personally has validated NAHRI’s mission and values and makes me proud to be a part of such a well-respected association. I’m very thankful for the opportunity to work on the exam and be surrounded by such great talent. Here’s to an awesome credential!”

Let’s embark on the new year with a fresh perspective on our professional roles. Be ready to learn. Be ready to test yourself. And be ready to hold that coveted CHRI credential.

Sincerely,

Jaclyn Fitzgerald

Director, NAHRI

jfitzgerald@hcpro.com