What is a Certified Revenue Integrity Professional?

A Certified Revenue Integrity Professional, also referred to as a CRIP, is a credentialed healthcare administration professional with advanced knowledge in revenue integrity management. As one of the key focuses in the administrative arena, more and more professionals who currently work in healthcare administration or who are studying to enter the field are interested in learning more about positions available in revenue cycle management. If you fit into this group of individuals, it is important to learn not just what CRIP certified professionals do, but also how to go about getting the training you need to become certified. Read on, and learn all of the basics in one platform.

What Does a Revenue Integrity Professional Do?

All healthcare facilities must review reimbursements and verify accuracy in billing and coding. Without any checks and balance procedures in place, it is impossible for the organization to ensure that they are collecting all of the revenue they are due. The revenue integrity management professional is in charge of coordinating the collection of target accounts between the administrative staff and the clinical personnel.

Revenue integrity professionals will analyze the current processes, review the coding of invoices, and verify that reimbursements are paid in full. They also play an important role in implementing new policies and sitting with management to develop a plan when certain regulations are not being complied with. Since managers are in charge of the integrity of the revenue cycle, they hold a great deal of responsibility.

How to Train to Work in Revenue Cycle Management

If this sounds like one of the many areas of healthcare administration that you want to work in, you need to start by pursuing a degree so that you can get a working knowledge of reimbursement regulations and how they apply to Managed Care Plans, Medicaid and other healthcare programs. You can start by earning a Bachelor’s degree majoring in Healthcare Administration. Then, enroll in a Master’s program in Healthcare Administration with a concentration on revenue cycling. If you already hold a degree, you can still enroll in an MBA program with a specialization in Healthcare Administration to master subjects and to become a stronger leader and communicator.

Resource: Top 20 Affordable Online Master’s Degree in Healthcare Administration Programs for 2015

How to Get Certified in Revenue Integrity

Certification is extremely important in revenue cycle operations. This is primary because it shows that you are competent individual who will be an asset to the organization and who has a commitment to the field. Before you can get certified, you need to meet the CRIP requirements that are set by the American Association of Healthcare Administrative Management. The only requirement set is that you must be an AAHM member in good standing.

If you have prepped for the 4 hour proctored exam that is administered online, you can schedule a test date in either March, July or November. Once you pass this certification exam, you will be a credentialed professional who has demonstrated competence in the current regulations for a period of 3 years. At that point you will be required to either show you have completed continuing education classes or that you can pass the certification exam again.

If you are ready to change your professional future, you can find preparation materials through the AAHAM. Be sure that you review each area of the exam closely and do not cram. Once you are comfortable, you can schedule a test date one of the 3 months the tests are given and then you can use the Certified Revenue Integrity Professional title.