Stepping up to the plate: The benefits and challenges of taking on a leadership role

Revenue integrity professionals bring a wealth of knowledge and experience to tackle some of the biggest challenges facing healthcare organizations. As the reimbursement landscape evolves and healthcare costs occupy a growing place in national debate, revenue integrity professionals will play a leading role in guiding their organizations. Revenue integrity professionals have the answers to questions that executives are asking and often no one grasps the purpose and implications of payer regulations quite as thoroughly.

Given that, it’s not surprising that revenue integrity professionals are finding their way to leadership roles and are being presented with opportunities to make their voices heard.

“I think that the area of revenue integrity has gotten so much more attention over the last decade. Ten years ago, you didn’t see things categorized as revenue integrity,” says Bruce Preston, CPC, director of revenue integrity at Grady Health System in Atlanta. “I think that the whole area of revenue integrity being recognized as a really important component of the revenue cycle has been nothing but a great thing because it’s helped hospitals to give the attention to that area that’s been needed for a long time.”

Revenue integrity has come a long way from the days when it was considered simply chargemaster maintenance or management, Preston adds. Organizations are beginning to understand that the humble chargemaster has far-reaching implications, and as a result the revenue integrity field has emerged with broader responsibilities and influence.

“I find myself being contacted more and more about what my thoughts are and what my opinions are around the different components of revenue integrity.” Preston says. “You have to have accurate charges; your pricing has to be competitive. And most of the time all of those fall into the realm of revenue integrity.”

As the focus on revenue integrity grows, so, too, will the challenges for professionals in that role. And that can yield a wealth of personal and professional rewards. Being a revenue integrity leader is both gratifying and challenging, with consistent opportunities to learn and improve processes, says Kimberly Yelton, RHIA, CCS, CDIP, AHIMA-approved ICD-10-CM/PCS trainer and director of revenue integrity at WakeMed Health & Hospitals in Raleigh, North Carolina. Revenue integrity places a high premium on personal integrity, she adds, because it’s a multi-disciplinary role that requires complete transparency. All of that adds up to the formula for a respected and influential leader.

“There is no doubt I see revenue integrity becoming more important to organizations and providing positive outcomes in the healthcare industry,” Yelton says. “The different professionals and skillsets that make up a revenue integrity team will only continue to build leadership skills and allow for professional growth.”

But remember, leaders are only as good as their teams, she adds. Nurture your revenue integrity department by being transparent and open to change, building positive relationships with all departments in your organization, cross-training staff, and performing root cause analysis with minimal touches. And once you’ve done all that, try to stay ahead of the curve.

“Important topics to revenue integrity leadership would include anything pertinent to the integrity of the revenue and to focus on a holistic view of financial stewardship,” Yelton says.  

Revenue integrity leaders and rising leaders should keep their finger on the pulse of their organizations and general industry trends. Those looking to leverage their expertise and join forces with their peers to establish the revenue integrity profession as a valued voice in public debate can volunteer for NAHRI’s Public Policy Committee. The Public Policy Committee will bring together NAHRI members to craft statements and public comments in line with NAHRI’s mission statement. If you’re interested in learning more, contact NAHRI Director Andrea Kraynak at akraynak@hcpro.com.