Top 11 Reimbursement Manager Certifications
This article provides an overview of the top certifications for reimbursement managers, outlining their requirements and benefits.
Published 17 min read
Certifications for a reimbursement manager are important in the job market because they demonstrate specialized knowledge and skill in the areas of healthcare finance, billing, coding, and reimbursement. Certification also shows that an individual has met the standards set by professional organizations, such as the American Academy of Professional Coders (AAPC) or the Healthcare Financial Management Association (HFMA). These certifications can help distinguish one candidate from another and can be used to demonstrate expertise and proficiency in a particular area. Additionally, employers may prefer to hire individuals with certifications due to their increased level of confidence in the individual’s knowledge and skills.
This article reviews some of the top certifications for Reimbursement Managers and explains how they can help to advance a reimbursement manager's career.
What are Reimbursement Manager Certifications?
Reimbursement manager certification is a professional credential that recognizes individuals with specialized knowledge in the process of obtaining reimbursement for healthcare services. It is designed to provide healthcare professionals with the skills and knowledge necessary to effectively manage reimbursement from third-party payers, including Medicare and Medicaid. This certification can help healthcare organizations improve their financial operations by providing reimbursement managers with the tools needed to maximize revenue from third-party payers. Reimbursement managers are responsible for understanding complex regulations, interpreting coding systems, negotiating contracts, and managing appeals processes. With this certification, reimbursement managers will be able to better understand how to obtain appropriate reimbursements for services rendered and how to resolve any discrepancies quickly and efficiently. Additionally, they will have an increased ability to identify areas of potential risk or noncompliance and take corrective action when needed. Ultimately, having a certified reimbursement manager on staff can lead to improved financial performance for any healthcare organization.
Pro Tip: Get certified as a Reimbursement Manager to gain an edge in the job market. Certification helps ensure employers that you have the required knowledge and skills to manage reimbursement processes effectively, and can also help you stand out from other candidates. Additionally, certification will provide you with access to industry-specific resources and networking opportunities.
Related: What does a Reimbursement Manager do?
Top 11 Reimbursement Manager Certifications
Here’s our list of the best certifications available to Reimbursement Managers today.
1. Certified Professional Reimbursement Manager (CPRM)
Certified Professional Reimbursement Manager (CPRM) is a professional certification program designed to provide healthcare reimbursement professionals with the knowledge and skills necessary to manage the financial aspects of health care delivery. The CPRM credential is offered by the Healthcare Financial Management Association (HFMA) and is recognized as a mark of excellence in healthcare reimbursement management.
The CPRM program requires candidates to complete an intensive course of study that covers topics such as reimbursement regulations, managed care, coding systems, billing practices, and financial analysis. Candidates must also pass a comprehensive exam that tests their knowledge and understanding of these topics. The program typically takes about six months to complete and consists of three components: pre-study materials, a two-day in-person seminar, and the final exam.
To become certified as a CPRM, individuals must have at least three years of experience in healthcare reimbursement management or related fields. They must also meet other eligibility requirements such as having earned a bachelor’s degree or higher from an accredited institution.
The cost for becoming certified as a CPRM varies depending on the type of membership you choose with HFMA. The cost ranges from $595 for non-members up to $1,295 for members who are enrolled in the HFMA’s Leadership Academy Program. Additionally, there may be additional costs associated with travel expenses for attending the two-day seminar if it is not held near your home location.
2. Certified Government Financial Manager (CGFM)
Certified Government Financial Manager (CGFM) is a professional certification program offered by the Association of Government Accountants (AGA). This certification recognizes individuals who have demonstrated the knowledge and skills necessary to manage public sector financial resources.
To become a CGFM, applicants must pass three computer-based examinations designed to test their knowledge in government financial management. The exams cover topics such as budgeting, accounting, auditing, financial reporting, internal controls, and financial systems.
The exams are administered by Prometric Testing Centers throughout the United States and overseas. Each exam has a time limit of two hours and consists of 100 multiple-choice questions. To pass an exam, applicants must score at least 70%.
It typically takes about six months to complete all three exams and earn the CGFM designation. Applicants should plan on spending at least 40 hours studying for each exam.
The cost of taking all three exams is $1,050 USD ($350 per exam). In addition, there is an annual fee of $50 USD to maintain the CGFM designation.
3. Certified Healthcare Financial Professional (CHFP)
The Certified Healthcare Financial Professional (CHFP) credential is a professional certification for healthcare finance professionals. It is offered by the Healthcare Financial Management Association (HFMA) and is recognized as the premier credential in healthcare finance. The CHFP designation demonstrates that the holder has achieved a high level of competence in financial management, accounting, and reimbursement practices within the healthcare industry.
To obtain the CHFP credential, applicants must have a minimum of two years of full-time experience in healthcare finance or related areas and must pass an exam administered by HFMA. The exam consists of 150 multiple-choice questions covering topics such as accounting principles, financial analysis, budgeting, reimbursement systems, and healthcare regulations.
The cost to take the CHFP exam varies depending on whether you are an HFMA member or not. For non-members, it costs $400 to take the exam; for members, it costs $300. In addition to this fee, there is also an application fee of $100 for all applicants regardless of membership status.
It usually takes between 6-12 weeks to complete the application process and receive your results after taking the exam. Once you have successfully passed the exam, you will be awarded your CHFP certification which is valid for three years from the date of issuance.
4. Certified Revenue Cycle Professional (CRCP)
Certified Revenue Cycle Professional (CRCP) is a professional certification program that recognizes the knowledge and skills of revenue cycle professionals. It is designed to validate competency in the areas of financial management, billing, coding, collections, compliance and patient accounts. The CRCP credential is awarded by the Healthcare Financial Management Association (HFMA).
The CRCP program requires applicants to have at least two years of experience in a healthcare finance role or an equivalent combination of education and experience. To become certified, applicants must pass an exam that covers topics such as reimbursement methodologies, regulatory compliance, coding and billing processes, collections strategies and financial analysis.
The exam consists of 150 multiple-choice questions and takes approximately four hours to complete. The cost for the exam is $450 for HFMA members and $550 for non-members. After passing the exam, candidates must renew their certification every three years by completing continuing education credits.
5. Certified Medical Reimbursement Specialist (CMRS)
A Certified Medical Reimbursement Specialist (CMRS) is a professional who has been certified by the American Medical Billing Association (AMBA) to provide medical reimbursement services. The CMRS credential is designed to recognize individuals who have demonstrated knowledge and experience in medical reimbursement and coding.
It typically takes approximately six months of study and preparation to obtain the CMRS certification. To become certified, applicants must pass a comprehensive exam that covers topics such as medical coding, billing, reimbursement principles, regulations, and compliance.
In order to be eligible for the CMRS certification exam, applicants must have a minimum of one year of experience in medical billing or coding or have completed a formal training program related to medical billing or coding. Applicants must also submit an application fee and proof of their education/experience.
The cost for the CMRS certification exam is $295 USD for members of AMBA and $395 USD for non-members.
6. Certified Professional Coder-Hospital Outpatient (CPC-HOP)
Certified Professional Coder-Hospital Outpatient (CPC-HOP) is a certification offered by the American Academy of Professional Coders (AAPC). It is designed to recognize individuals who have demonstrated expertise in coding for hospital outpatient services. This certification requires that coders demonstrate knowledge and proficiency in coding for outpatient services, including emergency department visits, ambulatory surgery, and other ancillary services.
It typically takes between six months to one year to complete the requirements for the CPC-HOP certification. To get certified, applicants must first pass a written exam that covers topics such as medical terminology, anatomy and physiology, and ICD-10 coding. After passing the written exam, applicants must then submit proof of professional experience in hospital outpatient coding. Finally, applicants must pass a practical exam that tests their ability to accurately code real-world scenarios.
The cost of the CPC-HOP certification varies depending on the applicant’s membership status with AAPC. For nonmembers, it costs $399 for the initial application fee and $350 for each additional exam retake. For members of AAPC, it costs $299 for the initial application fee and $250 for each additional exam retake.
7. American Academy of Professional Coders Certification (AAPC)
The American Academy of Professional Coders (AAPC) is a professional organization that certifies medical coders. It offers certification exams and training programs to help medical coders stay up-to-date on the latest coding standards and regulations.
To become certified, candidates must pass an exam that covers topics such as anatomy and physiology, ICD-10-CM coding, CPT coding, HCPCS Level II coding, and E&M coding. The exam typically takes 3 hours to complete and consists of 150 multiple-choice questions.
In order to take the exam, candidates must first register with AAPC and pay a fee of $399. After registering, they can access study materials such as practice tests and webinars to help them prepare for the exam. Once they have passed the exam, they will receive their certification in the mail within 2 weeks.
Once certified, medical coders must maintain their certification by completing continuing education courses every two years. This helps ensure that coders stay up-to-date on industry changes and best practices.
8. Healthcare Financial Management Association Certification (HFMA)
The Healthcare Financial Management Association (HFMA) is a professional association of healthcare finance professionals. It provides certification programs that recognize individuals who have met the highest standards in their field.
The HFMA Certified Healthcare Financial Professional (CHFP) certification is designed to demonstrate an individual’s expertise in healthcare finance and financial management. To obtain this certification, candidates must pass an exam that covers topics such as financial analysis, budgeting, and reimbursement systems. The exam takes about three hours to complete and costs $395 for members of HFMA and $495 for non-members.
To qualify for the CHFP exam, applicants must have at least two years of experience in healthcare finance or a related field. They must also meet certain educational requirements, including having a bachelor’s degree from an accredited college or university with coursework in accounting, economics, or business administration; or having completed an approved certificate program in healthcare finance or a related field.
Once the exam has been passed, the applicant will receive their CHFP designation and be recognized as a certified healthcare financial professional by HFMA. The certification is valid for three years and requires renewal every three years through continuing education credits.
9. National Association of Healthcare Revenue Integrity Certification (NAHRI)
The National Association of Healthcare Revenue Integrity (NAHRI) is a professional organization that provides certification for healthcare revenue integrity professionals. NAHRI certification is designed to recognize individuals who demonstrate a high level of knowledge and expertise in the field of healthcare revenue integrity.
The certification process requires applicants to pass an exam that covers topics such as healthcare reimbursement, compliance, patient billing, coding, auditing, and financial management. The exam consists of 100 multiple-choice questions and must be completed within two hours.
To become certified by NAHRI, applicants must meet certain prerequisites including two years of experience in the healthcare revenue cycle or completion of an approved training program. Applicants must also pay a fee which is currently $295 for members and $395 for non-members.
Once all requirements are met, applicants will receive their NAHRI Certification within four to six weeks after passing the exam. The certification is valid for three years from the date it was issued and can be renewed by taking additional courses or attending conferences related to healthcare revenue integrity.
10. American Health Information Management Association Certification (AHIMA)
AHIMA Certification is a voluntary credentialing program offered by the American Health Information Management Association (AHIMA) to recognize individuals who demonstrate excellence and knowledge in the field of health information management. The AHIMA Certification Program offers credentials for professionals in various specialties, including coding, health data analysis, privacy and security, clinical documentation improvement, health informatics, and more.
It typically takes about two years to complete the requirements for an AHIMA certification. In order to become certified, applicants must meet certain educational requirements and pass an examination. Applicants must also have a minimum of two years of professional experience in the field they are applying for certification in.
To get an AHIMA certification, applicants must first review the eligibility criteria for the specific credential they are interested in obtaining. They will then need to register with AHIMA and submit their application along with all required documents and fees. After submitting their application, applicants will receive a confirmation email from AHIMA with instructions on how to schedule their exam date and time.
The cost of an AHIMA certification varies depending on which credential you are applying for; however, most certifications range from $200-$400 USD.
11. International Association of Healthcare Professionals Certification (IAHCP).
The International Association of Healthcare Professionals (IAHCP) Certification is a professional certification program that recognizes the highest standards of excellence in healthcare practice. It is designed to recognize professionals who have achieved a high level of proficiency in their field and demonstrate commitment to the profession.
The IAHCP Certification process involves an extensive review of an individual's qualifications, experience, and accomplishments. The review includes a comprehensive evaluation of the applicant's education, training, work history, and other relevant information. Once the review is complete, applicants must pass an examination to receive their certification.
The IAHCP Certification process typically takes between six months and one year to complete. During this time, applicants will be required to submit all necessary documentation for review and complete the exam. After successful completion of the exam, applicants will receive their certification from the IAHCP.
To obtain IAHCP Certification, applicants must first meet certain eligibility requirements. These include having at least three years of healthcare experience in their field or related fields; holding a valid license or certification in their field; completing a minimum number of continuing education credits; and passing an examination administered by the IAHCP.
The cost for obtaining IAHCP Certification varies depending on the individual's qualifications and experience level. Generally speaking, it can range from several hundred dollars to several thousand dollars.
Do You Really Need a Reimbursement Manager Certificate?
The answer to this question depends on your individual circumstances. If you are looking for a career in reimbursement management, then a certificate may be beneficial to you. A certificate can help demonstrate to potential employers that you have the knowledge and skills necessary to excel in the field of reimbursement management. In addition, certification can also provide you with an advantage when competing for jobs, as it may give employers assurance that you are competent and knowledgeable about the subject matter.
However, if you already have experience in reimbursement management or if you have a degree in a related field, then a certificate may not be necessary. Employers may recognize your experience and education as sufficient credentials to qualify for the job. Therefore, it is important to evaluate your individual qualifications before deciding if obtaining a reimbursement manager certificate is the right choice for you.
Related: Reimbursement Manager Resume Examples
FAQs About Reimbursement Manager Certifications
1. What is a Reimbursement Manager Certification?
Answer: A Reimbursement Manager Certification is a professional certification that demonstrates knowledge and expertise in the area of reimbursement management. It recognizes individuals who have achieved specialized training and education in the field, including financial and administrative aspects of managing health care reimbursements.
2. What are the benefits of having a Reimbursement Manager Certification?
Answer: Having a Reimbursement Manager Certification allows individuals to demonstrate their knowledge and understanding of reimbursement management, which can be beneficial for career advancement. It also provides individuals with the opportunity to stay up-to-date on new developments within the industry, as well as gain additional skills that can help them succeed in their current role or pursue new opportunities.
3. How do I become certified as a Reimbursement Manager?
Answer: To become certified as a Reimbursement Manager, you must complete an approved program from an accredited organization such as the American Academy of Professional Coders (AAPC). The program typically involves passing an exam after completing coursework in topics such as medical coding, insurance billing, healthcare ethics, and more.
4. How long does it take to get certified?
Answer: The amount of time it takes to obtain certification depends on the individual’s level of experience and commitment to studying for the exam. Generally speaking, most people are able to obtain certification within six months if they dedicate themselves to studying for at least two hours per day.
5. Is there any continuing education requirement once I am certified?
Answer: Yes, once you are certified as a Reimbursement Manager, you must complete at least 10 hours of continuing education credits every year in order to maintain your certification status. These credits can be earned through approved courses or activities related to reimbursement management topics such as medical coding updates or healthcare compliance regulations.