Training and selecting revenue integrity staff

Friday, June 7, 2024

Q: How do you train professionals hired into revenue integrity roles?

Kelly Bowley, RN, MBA, CRCE, senior director of healthcare business transformation, revenue cycle, at FTI Consulting in Washington, D.C.: My first revenue integrity job managed teams across multiple facilities. At each facility we had a registered nurse with support staff, and having those [individuals who] were prior clinicians helps. There really is no program that teaches you how to function in a revenue integrity role because the roles, responsibilities, and tasks that are being assigned are constantly evolving. Edits, what you can and can’t bill, and modifiers are always changing. Even if you had a manual, the maintenance of it and the constant upkeep would be a lot just because of the evolving regulations around that. If you have a mixture of skill sets on the team, that’s what really makes it more robust and allows you to really be very effective in revenue monitoring.

Kelly Henneman, vice president of revenue integrity at University of Maryland Medical

System in Baltimore, Maryland: For us, it’s on-the-job training. We do not have a manual. The technical aspects of the job can be challenging, and it’s really taking the time to onboard and partner people up with others on the team that have experience. Unless it’s management, or coders, we hire right out of school. We can train folks, and they can partner up with buddies and learn on the job.

Editor’s note: This article was excerpted from the 2024 State of the Revenue Integrity Industry Survey Report. Read the full report here.

Found in Categories: 
Program Management, Revenue Integrity