A certified revenue cycle executive is a healthcare administrator who is accredited in revenue cycle management. It is their job to ensure the doctor's office or hospital is paid for the services it provides. While the job is not glamorous, medical establishments cannot function without it. Improperly managed revenue cycles can cause the closure of medical offices, limiting the availability of healthcare within the community.

What is Revenue Cycle Management?

Revenue cycle management is basically the process of ensuring a healthcare provider gets paid in a timely manner for services it performs. This entails determining insurance eligibility, accepting copays properly, coding services correctly on claims, and collecting payments. It also involves dealing with any denied claims, which according to Healthcare IT News, says is the source of the vast majority of missed revenue opportunity. Efficiency and the effective use of both staff and technology are also important considerations for administrators charged with revenue cycle management.

What is a Certified Revenue Cycle Executive?

Certified revenue cycle executive is a designation awarded by the American Association of Healthcare Administrative Management, a professional organization dedicated to providing advocacy, networking, education, and certification for professionals in the field of healthcare revenue cycle management. Requiring recipients to demonstrate knowledge of revenue cycle management, communication skills and critical thinking ability, the certified revenue cycle executive credential is the highest of the four credentials the association awards. Intend for senior administrators, it is the healthcare revenue cycle management field's equivalent to the passing the bar in law or earning the certified public accounting designation in accounting. There are actually two accreditations available. The certified revenue cycle executive – institutional is for professionals working in a health system or hospital; the certified revenue cycle executive – professional is for people employed by doctors' offices and clinics. Dual certification is possible.

What is Required to Become a Certified Revenue Cycle Executive?

Earning accreditation requires successfully completing a comprehensive exam. To sit for the exam, a person must be a member of the American Association of Healthcare Administrative Management with four years of experience in healthcare or a related field. An appropriate associate or bachelor's degree may earn an educational waiver, which can reduce the experience requirement to two years. The proctored exam allows participants eight hours to complete a variety of question formats ranging from multiple-choice to essay. The exam's four parts focus on patient access or front desk procedures, billing, collections and credit, and revenue cycle management. Professionals interested in dual accreditation must complete either the institutional or the professional accreditation first. After receiving their initial credential, they may return to complete a three-section exam to earn the remaining credential.

How Do Participants Prepare for the Certified Revenue Cycle Executive Exam?

Preparation for the accreditation exam is self-directed, but the American Association of Healthcare Administrative Management does offer some tools to help. A downloadable study guide, online practice exams, a study manual and webinars are available for those interested.

Related Resource: Health Education Specialist

Patients seeking healthcare services from a doctor's office, clinic or hospital are understandably more concerned with their own situation than the financial health of the provider. But, a poorly managed revenue cycle can trigger the closure of a medical establishment, potentially reducing the community's access to medical care. Despite operating primarily behind the scenes, administrators like certified revenue cycle executives play a critical role in healthcare delivery by working to ensure the financial health of the medical establishments that employ them.