Top 10 Reimbursement Specialist Certifications

Certifications are important for a reimbursement specialist in the job market because they demonstrate to potential employers that an individual has the necessary knowledge and skills to perform the job. Certifications help to ensure that reimbursement specialists are well-trained and educated, and provide employers with assurance that they will be able to perform the tasks required. They also demonstrate a commitment to professional development, which can help set a candidate apart from other applicants. Additionally, certifications can give access to higher-level positions and better pay, making them an important part of any reimbursement specialist’s career advancement.

The purpose of this article is to review the top certifications for Reimbursement Specialists and explain how they can help to enhance and advance a Reimbursement Specialist's career.

What are Reimbursement Specialist Certifications?

Reimbursement specialist certification is a professional credential that demonstrates a comprehensive understanding of healthcare reimbursement rules and regulations. It is offered by the Healthcare Financial Management Association (HFMA), an organization dedicated to providing resources to healthcare finance professionals. With this certification, reimbursement specialists are able to demonstrate their knowledge of the industry and gain an edge in the competitive job market.

Reimbursement specialist certification can help reimbursement specialists stay current on the ever-changing landscape of healthcare reimbursement regulations. This not only helps them stay compliant with new rules and regulations, but also allows them to provide more accurate and up-to-date information to employers and patients alike. Additionally, certification can give job seekers a competitive edge when applying for jobs in the field. Finally, it provides a sense of professional recognition among peers and employers, which can lead to increased job security and better career opportunities.

Pro Tip: Obtaining certification in reimbursement specialist can help you stay ahead of changes in the industry and provide a competitive edge when applying for positions. Additionally, many employers look favorably on those with certification as it demonstrates mastery of the subject matter and commitment to their profession.

Related: What does a Reimbursement Specialist do?

Top 10 Reimbursement Specialist Certifications

Here’s our list of the best certifications available to Reimbursement Specialists today.

1. Certified Professional Coder (CPC)

Certified Professional Coder (CPC) is a professional certification for medical coding professionals. It is offered by the American Academy of Professional Coders (AAPC). The CPC credential demonstrates an individual’s knowledge and proficiency in medical coding and billing.

It typically takes between 6 months to 1 year to prepare for the CPC exam, depending on how much experience you have with medical coding and billing. To get the CPC certification, you must pass the CPC exam which consists of 150 multiple-choice questions. The exam covers topics such as anatomy, physiology, medical terminology, ICD-10-CM codes, HCPCS Level II codes, CPT codes and more.

The cost of taking the CPC exam varies depending on your AAPC membership status. For non-members, it costs $399 and for members it costs $299.

2. 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). This certification is designed to recognize individuals who have demonstrated proficiency in medical reimbursement processes and procedures. The CMRS credential is intended to demonstrate that the individual has the knowledge and skills necessary to accurately process claims, manage accounts receivable, and ensure proper reimbursement for services provided.

It typically takes about six months to complete the requirements for the CMRS certification. Individuals must first pass an exam administered by the AMBA, which covers topics such as coding, billing, reimbursement, compliance, and more. After passing the exam, applicants must submit proof of at least two years of experience in medical billing or coding in order to be eligible for certification.

In order to obtain a CMRS certification, individuals must submit an application form along with a fee of $299 USD. The fee includes a one-time registration fee of $199 USD and an annual renewal fee of $100 USD. Once approved, applicants will receive their certification within four weeks.

The CMRS credential is valid for three years from the date it was issued and must be renewed every three years in order to remain current. Renewal requires completion of continuing education credits and payment of an annual renewal fee of $100 USD.

3. Certified Healthcare Financial Professional (CHFP)

Certified Healthcare Financial Professional (CHFP) is a professional certification program designed to recognize individuals who demonstrate proficiency in the financial management of healthcare organizations. The CHFP credential is offered by the Healthcare Financial Management Association (HFMA). It is intended for those working in or aspiring to work in the field of healthcare finance, including both clinical and administrative professionals.

The CHFP certification requires applicants to have at least three years of experience in healthcare finance, as well as a bachelor’s degree or higher from an accredited college or university. Applicants must also pass a comprehensive exam that covers topics such as accounting principles, reimbursement systems, financial analysis and decision-making, budgeting and forecasting, cost containment strategies, and regulatory compliance.

It typically takes approximately 6-9 months to complete the CHFP certification process from start to finish. During this time period, applicants are required to complete an online application form and submit all necessary documentation to HFMA. After submitting their application materials, applicants will be notified within 8 weeks if they have been accepted into the program. Once accepted into the program, applicants must register for and take the CHFP exam within 12 months of acceptance.

The cost of obtaining the CHFP certification varies depending on whether you are an HFMA member or non-member. For HFMA members, it costs $450 for initial registration fees plus $400 for each attempt at taking the exam; for non-members it costs $650 for initial registration fees plus $500 for each attempt at taking the exam.

4. American Academy of Professional Coders (AAPC)

The American Academy of Professional Coders (AAPC) is a professional organization that provides certification, training, and resources to medical coding professionals. It is the largest medical coding organization in the United States.

It takes approximately three to six months to complete the AAPC certification process. To get certified, you must first pass an exam. The exam consists of multiple choice questions on topics such as medical terminology, anatomy and physiology, coding systems, and reimbursement methodologies. After passing the exam, you will receive your Certified Professional Coder (CPC) credential from the AAPC.

The cost of getting certified through the AAPC varies depending on the type of certification you are seeking. For example, if you are seeking a CPC credential, it will cost around $300 for members and $400 for non-members. Other certifications may have different costs associated with them.

Overall, becoming certified through the AAPC is an excellent way to demonstrate your knowledge and expertise in medical coding and can help you advance your career in this field.

5. Certified Revenue Cycle Representative (CRCR)

A Certified Revenue Cycle Representative (CRCR) is a professional designation that recognizes the expertise and knowledge of individuals who work in the healthcare revenue cycle. The CRCR certification is offered by the Healthcare Financial Management Association (HFMA).

The CRCR certification requires candidates to have at least two years of experience in a revenue cycle position, or one year of experience with an associate degree in a related field. Candidates must also pass an exam that covers topics such as reimbursement, coding and compliance, patient access, and billing operations.

It typically takes three to six months to prepare for the CRCR exam. Candidates can study on their own or take an online course from HFMA. They can also attend workshops and seminars offered by HFMA or other organizations.

The cost of taking the CRCR exam is $395 for HFMA members and $495 for non-members. In addition to the exam fee, candidates may also need to pay for study materials and/or courses.

6. National Association of Healthcare Revenue Integrity (NAHRI)

The National Association of Healthcare Revenue Integrity (NAHRI) is a professional organization that provides education, resources, and networking opportunities for healthcare revenue integrity professionals. The organization was founded in 2008 to promote the highest standards of ethical conduct and best practices in healthcare revenue integrity.

Membership in NAHRI is open to individuals who work in the field of healthcare revenue integrity. This includes individuals who are employed by health systems, hospitals, physician practices, managed care organizations, insurance companies, and other entities related to healthcare finance. Membership is also available to students pursuing a degree or certification related to healthcare revenue integrity.

Membership applications can be submitted online through the NAHRI website. There is an annual membership fee of $195 for individual members and $495 for organizational memberships.

Once your application has been accepted, you will receive an email confirmation with instructions on how to access your member account. You will also receive a welcome packet with additional information about NAHRI’s services and benefits.

7. Certified Medical Billing and Coding Specialist (CMBCS)

Certified Medical Billing and Coding Specialist (CMBCS) is a certification program that certifies individuals who have the knowledge, skills, and abilities to accurately code medical services and procedures for reimbursement. This certification is offered through the American Academy of Professional Coders (AAPC). The certification requires passing an exam, which covers topics such as anatomy, medical terminology, coding systems, and insurance regulations.

It typically takes 3-6 months to complete the requirements for the CMBCS certification. To get certified you must first become a member of AAPC by registering online or by mail. Once registered, you can purchase study materials from AAPC or other sources to prepare for the exam. After completing your studies, you can then schedule and take the exam at an approved testing center.

The cost of becoming certified depends on whether you choose to become a member of AAPC or not. If you are not a member, the cost of taking the exam is $399; if you are a member it is $299. Additionally, there may be additional costs associated with purchasing study materials or attending training courses.

8. American Health Information Management Association (AHIMA)

The American Health Information Management Association (AHIMA) is a professional association of healthcare professionals who specialize in health information management. AHIMA’s mission is to empower its members and the healthcare industry to ensure quality health information and services are delivered effectively, securely, and ethically.

It takes approximately 2-3 weeks to become an AHIMA member after submitting the application form and payment. To become a member, you must complete the online membership application form on the AHIMA website. You will need to provide your contact information, educational background, and other relevant details about your experience in health information management.

The cost for an individual membership is $175 per year for U.S./Canada members or $200 per year for international members. Student memberships are available at a reduced rate of $50 per year. There are also discounts available for groups of five or more individuals joining at once.

In addition to becoming a member, there are various certifications that can be obtained through AHIMA including Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), and Certified Professional in Healthcare Quality (CPHQ). Each certification requires additional fees as well as successful completion of an exam specific to that certification.

9. Professional Association of Healthcare Coding Specialists (PAHCS)

The Professional Association of Healthcare Coding Specialists (PAHCS) is a professional organization dedicated to promoting excellence in healthcare coding and advancing the profession. It is an independent, non-profit organization that serves as a resource for healthcare coding professionals.

To become a member of PAHCS, you must have at least two years of experience in healthcare coding or be currently enrolled in a program to become certified in healthcare coding. There is no time limit for becoming a member; however, members must renew their membership every year.

To join PAHCS, you will need to fill out an application form and pay an annual membership fee. The fee varies depending on the type of membership you choose: individual ($50), student ($25), or corporate ($250).

In addition to the annual membership fee, members may also have access to exclusive benefits such as discounts on continuing education courses and conferences, access to job postings, networking opportunities with other members, and more.

10. Healthcare Financial Management Association (HFMA)

The Healthcare Financial Management Association (HFMA) is a professional membership organization for healthcare finance professionals. It provides education and resources to help healthcare organizations improve their financial performance. HFMA members are responsible for the financial management of hospitals, health systems, physician practices, long-term care facilities, managed care organizations, and other related organizations.

To become an HFMA member, you must have a minimum of two years of experience in the healthcare industry and meet certain educational requirements. You can apply online or by mail. The application fee is $150 for individuals or $300 for organizations.

Once your application has been approved, you will receive an email with instructions on how to access your member benefits. This process typically takes about 2 weeks from when your application is submitted.

Membership benefits include access to exclusive content such as webinars, podcasts, and white papers; discounts on conferences and events; networking opportunities; career development tools; and more.

Do You Really Need a Reimbursement Specialist Certificate?

Whether you need a Reimbursement Specialist Certificate depends on the type of position you are looking for. If you are seeking a job in which reimbursement is a major component, then having this certification may be beneficial. It demonstrates to employers that you have received training and education in the field and have the knowledge necessary to carry out the duties of a reimbursement specialist.

Having this certificate may also give you an edge over other candidates who do not have it. Employers may view those with the certification as more qualified for the position since they have already taken steps to obtain additional knowledge in their field. This can make your resume stand out when applying for positions that require reimbursement experience or expertise.

However, if your primary focus is not on reimbursement, then a Reimbursement Specialist Certificate may not be necessary. You can still demonstrate your knowledge and skills in this area without having obtained the certification by listing relevant experience or coursework on your resume. Additionally, if you plan to pursue further education or training related to reimbursement, obtaining the certificate could provide additional opportunities for career advancement down the road.

In conclusion, whether or not you need a Reimbursement Specialist Certificate depends on what kind of job you are looking for and how much emphasis is placed on reimbursement skills and experience in that particular role. If these criteria are important factors for success in your desired position, then obtaining this certification could potentially help set you apart from other job applicants and give you an advantage when applying for positions that require reimbursement expertise.

Related: Reimbursement Specialist Resume Examples

FAQs About Reimbursement Specialist Certifications

1. What is a Reimbursement Specialist Certification?

Answer: A Reimbursement Specialist Certification is a credential offered by the American Academy of Professional Coders (AAPC) that demonstrates competency in medical coding, reimbursement processes, and other related healthcare topics.

2. What are the requirements for becoming certified as a Reimbursement Specialist?

Answer: To become certified as a Reimbursement Specialist, you must pass an exam administered by the AAPC and have at least two years of professional experience in the field.

3. How long does it take to become certified as a Reimbursement Specialist?

Answer: The certification process typically takes between 6-8 weeks from start to finish.

4. What is the cost of obtaining a Reimbursement Specialist Certification?

Answer: The cost for obtaining a Reimbursement Specialist Certification typically ranges from $400-$600 depending on the type of certification you pursue.

5. Is there any additional continuing education required to maintain my certification?

Answer: Yes, once you have obtained your certification, you will be required to complete 60 hours of continuing education every two years in order to maintain your certification status.