Q&A: Revenue integrity background and experience

Monday, June 1, 2020

Editor's note: This Q&A is included in NAHRI's 2020 State of the Revenue Integrity Industry Report. Click here to read the full report and participate in 2020 Revenue Integrity Week activities. 


The following is a question and answer session with Caroline Znaniec, managing director of CohnReznick LLP’s Healthcare Advisory Practice in Baltimore, on revenue integrity background and experience as reported in NAHRI’s 2020 State of the Revenue Integrity Industry Survey. Znaniec is a NAHRI Advisory Board member.


Q. Nearly 85% of respondents hold one or more credentials. What value can credentials bring to revenue integrity professionals and the overall state of the industry?

A. Credentials are a great way to demonstrate proficiency and understanding that sets one apart from their peers. Adding a professional credential can especially aid the addition of more junior staff to a growing industry such as revenue integrity where their knowledge is obtained on the job more than a classroom. Adding a credential supports the knowledge obtained but also enforces how to translate that knowledge in a broader perspective.


Q. Approximately 27% of respondents have more than 20 years of industry experience. What knowledge and experience areas can new and veteran revenue integrity professionals seek education on to ensure they are well prepared for the future of the profession?

A. The outlook for improving performance across many industries and professions, not just healthcare or revenue integrity, will rely heavily on the ability to translate operations into technology. Education efforts should provide for the technical requirements, along with how to apply artificial intelligence into existing technology workflows. For example, implementing automated charge capture based on the completion of an order set and using predictive analysis to identify charge capture opportunities.


Q. Most respondents come from coding (34%) or chargemaster (22%) backgrounds. How can this experience prepare professionals for a career in revenue integrity?

A. The evolution of revenue integrity for many organizations began in coding or charge description master (CDM) roles. The foundation for ensuring the proper identification, capture, and reporting of items, services, and procedures is dependent on the CDM and coding functions. To be successful in either coding or CDM, the professional must also have holistic understanding of revenue cycle processes.


Q. What advice would you give to professionals who are new or looking to break into revenue integrity?

A. My advice to new revenue integrity professionals is to understand that the profession is ever changing. It takes much dedication to stay informed of the regular technical and operational changes. It can be exhausting. But if you have a passion for a higher-pace profession that can easily demonstrate results and performance, this is a great profession.


Q. What advice would you give to experienced revenue integrity professionals looking to further their careers?

A. My advice to experienced professionals looking to advance their career is to transfer your knowledge to the next generation.


Found in Categories: 
Program Management, Revenue Integrity