Certified Revenue Cycle SpecialistA certified revenue cycle professional works in a mid-management position within the financial healthcare system. Responsibilities involve accurately monitoring patient registration, completing billing procedures, following credit and collection protocols, and managing revenue cycles. Holding revenue cycling certification assures employers that healthcare financial personnel are knowledgeable about healthcare compliance regulations, possess excellent leadership skills, and demonstrate expertise with medical finance practices.

Revenue Cycling: Why Is It Important?

Revenue cycling involves handling critical patient data for billing purposes, according to Med Page Today. The process begins with patient admission, continues through to discharge, and ends with final receipts paid. The sensitive nature of the job demands ethical, accurate collection of healthcare information. Revenue cycle professionals are expected to protect patient confidentiality while appropriately coding medical diagnoses and procedures for billing purposes.

Qualifications for Revenue Cycle Personnel

Revenue cycle personnel must hold at least an associate’s degree from an accredited program in some area of public health, preferably with a focus on medical coding and accounting practices. Many upper-level professionals will have a bachelor’s or master’s in the field. In addition to an appropriate degree, on-the-job experience in healthcare finance is required before obtaining certification. Certification demonstrates that professionals have the expertise, job commitment and leadership skills necessary to work in medical finance positions, according to the American Association of Healthcare Administrative Management (AAHAM). The AAHAM provides three levels of certification:

  • Level 1 – The Certified Revenue Cycle Specialist (CRCS) for entry-level staff looking to pursue higher level positions and demonstrate competence with basic billing and patient coding procedures. One year of experience is recommended before taking the exam.
  • Level 2 – The Certified Revenue Cycle Professional (CRCP) for mid-level supervisory personnel aspiring to document their expertise and skills while working towards executive level positions. Two years of experience or an educational waiver is required before attempting the exam.
  • Level 3 – The Certified Revenue Cycle Executive (CRCE) for senior executives looking to hone their strategic, financial management skills. A minimum of four years experience or an educational waiver is required prior to taking the exam.

Each certification test requires examinees to demonstrate increasingly advanced knowledge about: patient access, front desk procedures, billing, credit and collections procedures, and revenue cycle management. Based on workplace setting, applicants take one of two test versions:

  • Employment in institutional settings, such as hospitals,rehabilitation centers, or nursing care facilities
  • Employment in professional settings, such as physician’s offices or clinics

Benefits of Becoming a Certified Revenue Cycle Professional

Certification for mid-level managers in medical finance jobs benefits the employee and the employer. Employees gain recognition for their professional expertise and skills, allowing them to move into higher level supervisory positions which in turn improves earning potential and career sustainability. Employers gain confirmation that employees will uphold strong work ethics, adhere to healthcare standards, follow compliance regulations, and demonstrate increased competencies with financial healthcare practices.

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Revenue cycle professionals are critical to the success of the financial healthcare management system. They ensure confidentiality while maintaining accurate patient records. Becoming a certified revenue cycle professional is a good choice for mid-level employees in healthcare finance positions looking to advance within the field while providing quality patient healthcare services.