Revenue Cycle for HIM Professionals
Recorded: September 21, 2017
CEU: 1.0 – Performance Improvement
With the shift from volume to value, opportunities abound for HIM professionals to play a pivotal part in healthcare revenue cycle management—helping their organizations avoid penalties, meet compliance, ensure proper reimbursement and improve patient outcomes.
According to AHIMA, revenue cycle management positions are in high demand, including the following opportunities:
Revenue cycle auditor, revenue integrity auditor, or revenue integrity analyst—responsible for identifying areas of noncompliance in the areas of coding, charge capture and revenue cycle data collection practices
Revenue cycle manager or revenue cycle integrity coordinator—responsible for working with practice management staff in day-to-day operations on issues related to the revenue cycle functions, and leading process improvement and training
In these positions, the HIM professional focuses on ensuring proper use of information in revenue cycle operations and meeting compliance. Knowledge of regulatory guidelines and requirements is more important than ever—working with staff and providers to make sure all regulations are met and that bills are submitted with accurate and compliant data.
With decades of experience in information governance, HIM is perfectly positioned to guide revenue cycle integrity.
Likewise, clinical documentation improvement (CDI) specialists are strong candidates for careers in revenue cycle management or auditing. In addition to relevant experience, AHIMA notes some of the most important competencies for recruiters and candidates to consider:
Strong interpersonal and communication skills
Ability to manage multiple projects
Problem-solving and decision-making skills
Ability to analyze financial and operating information
Exceptional leadership skills, especially working with a multidisciplinary team
Ability to work independently and collaboratively
On the auditing side, knowledge and understanding in the following areas is essential:
Medical terminology and coding
State, federal and Medicare regulations
Revenue cycle processes/terminology to communicate corrective action recommendations
HIM is transitioning from a distinct role in the HIM department into a broad range of competencies required to manage information and ensure data integrity throughout the healthcare enterprise.
Join Richard LeBoutillier, MPA, RHIA, CPHQ, CHC, Director, Clinical Revenue Integrity, Conifer Health Solutions and Board Member, TxHIMA, as he covers this important topic: Revenue Cycle for HIM Professionals.
Richard LeBoutillier, MPA, CPHQ, CHC
Conifer Health Solutions
Director, Clinical Revenue Integrity
Richard is currently the Director for Clinical Revenue Integrity services at Conifer Health Solutions in Frisco, Texas. In this capacity he works with the clinical documentation improvement program, charge capture review program, charge description master management, and facilitates regulatory compliance by providing support to hospitals across the country. He has over twenty years of healthcare experience, covering provider-based and consulting work. He received a Bachelor of Science from Cook College at Rutgers University in microbiology and a Master of Public Administration from Seton Hall University in healthcare administration. He received a Post Baccalaureate Certificate in health information management from the University of Illinois Chicago. He also completed a Certificate in healthcare risk management from New York University. In addition, Richard is a Registered Health Information Administrator (RHIA) Certified Professional in Healthcare Quality (CPHQ), as well as Certified in Healthcare Compliance (CHC).
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