Within the typical healthcare organization, few roles are more critical to the long-term financial integrity of the facility than that of the certified revenue cycle specialist. In this capacity, professionals ensure the long-term financial viability of the hospital or clinic by handling patient billing data and executing key tasks within the revenue cycle. This includes initial billing and invoicing, arranging for payment and payment processes, overseeing collections and accounts receivable, and ensuring a smooth financial system that properly accounts for all services rendered. The revenue cycle specialist works collaboratively with accountants, human resources professionals, and financial analysts, to properly oversee every aspect of payment and collections. They'll also be the first to spot financial problems or irregularities.

Why Does a Healthcare Facility Need a Revenue Cycle Specialist?

Revenue cycle specialists are designed to "fill in the gaps" of a hospital or clinic's financial operation. Their goal is to make sure that every aspect of billing and budgeting runs smoothly, whether it's accounting for patient treatments, calculating the cost of patient intake, issuing bills for payment by the patient and their insurance company, or collecting on past-due obligations. Since hospitals and clinics rely on collection of outstanding balances to fund their operations, oversight of these procedures and their associated departments is absolutely essential for long-term facility survival.

Are There Specific Educational Requirements to Become a Certified Specialist?

Those who wish to work as a certified revenue cycle specialist typically need to have an extensive educational background in business, accounting, and finance. They need to understand what constitutes an ethical financial disclosure, how hospitals are funded, the interaction of insurance and personal healthcare liability, and the nature of managing diverse groups of teams that all have separate responsibilities within the revenue cycle. Entry-level professionals in this field may have a bachelor's degree, but an increasing number of certified revenue cycle specialists bring with them a graduate-level education. Additionally, some professional certifications are required to land and maintain the job.

A Certified Revenue Cycle Specialist Examination is Required

Without certification by the American Association of Healthcare Administrative Management, those who aspire to enter into this profession may be unable to do so. The CRSC examination is the entry-level exam for those who wish to fill this role, with two higher-level exams known as the Certified Revenue Cycle Professional and the Certified Revenue Cycle Executive. These two examinations are generally optional, though they will help the professional advance into more senior roles within a typical clinic.

No matter which CRSC exam is taken, job in this industry abound at today's hospitals and clinics. The healthcare industry is growing and, according to the Bureau of Labor and Statistics, both the demand and compensation for professionals in this industry are on the rise.

Related Resource: Healthcare Administration Certificates

A Detail-Oriented Role for Financial Professionals in Healthcare

Today's hospitals are growing quickly, and they require close oversight to ensure compliance with federal laws, adherence to ethical accounting and reporting standards, and proper budgets that make it possible for the facility to function on a long-term basis. There are plenty of departments charged with making sure these things happen, but only a revenue cycle specialist oversees all of those departments. By taking the certified revenue cycle specialist examination and coordinating numerous financial departments within the typical medical facility, this position makes it possible for healthcare to be more widely available, more affordable, and more sustainable.