What HIM Certification Should You Choose? A Guide to Eligibility & Testing
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At first glance, the ‘alphabet soup’ of health information management (HIM) credentials can be a bit overwhelming. With so many options, you want to be sure that you’re making the right choice. Obtaining a credential takes time, money, and effort—which is why it’s important to do your homework in advance to find the credential that makes the most sense for you, given your unique career aspirations.
Determining your career goals
Ask yourself this question: In what specific area of HIM are you most interested? Coding? Clinical documentation improvement (CDI)? Release of information (ROI)? Electronic health records (EHR)? HIPAA? Something else? Are you vying for a specific position, or has your employer asked you to obtain a credential to keep your current job? The good news is that with HIM, you have many career paths to pursue—and many credentials that help demonstrate your expertise.
This article delves into some of the most popular HIM credentials and why you might want to consider one—or more—of them.
General HIM credentials
1. Registered Health Information Administrator (RHIA)
About: The RHIA credential denotes one’s knowledge of the medical, administrative, ethical, and legal requirements and standards related to healthcare delivery as well as the privacy of protected patient information.
Who should have it: Consider this credential if you’ve met certain academic requirements, and you’re looking for career advancement into roles such as: DRG validator, quality improvement analyst, implementation support specialist, cancer registrar, health information technician, professor, ICD-10 educator, mapping specialist, e-MPI manager, or coding trainer.
Those with an RHIA certification often ultimately decide to pursue managerial roles such as HIM manager, program director, HIM director, regional director of HIM, director of coding, or vice president of coding
2. Registered Health Information Technician (RHIT)
About: The RHIT credential denotes one’s ability to use computer applications to assemble and analyze patient data to improve patient care or control costs.
Who should have it: Consider this credential if you’ve met certain academic requirements, and you’re looking for career advancement into many of the same roles listed above for the RHIA credential. Those with an RHIT certification also frequently pursue the role of cancer registrar.
Coding credentials that span inpatient and outpatient settings
1. Certified Coding Associate (CCA)
About: The CCA credential denotes medical coding competency in any setting, including both hospitals and physician practices.
Who should have it: Consider this credential if you have some coding experience (ideally six months or more) and would like to demonstrate competency in an increasingly competitive job market.
2. Certified Risk Adjustment Coder (CRC)
About: The CRC credential denotes one’s ability to read a medical chart and assign the correct ICD-10-CM codes for a wide variety of clinical cases and services for various risk-adjustment models.
Who should have it: Consider this certification if you’d like to work in either an office or facility setting and specialize in risk-based coding. This specialization is important in light of CMS’ gradual shift to value-based purchasing.
Inpatient-specific coding credentials
1. Certified Coding Specialist (CCS)
About: The CCS credential denotes one’s mastery of the ICD-10-CM and CPT coding systems.
Who should have it: Consider this credential if you’ve met certain eligibility requirements and seek career advancement into inpatient positions such as DRG validator, health information technician, coding professional, clinical documentation improvement specialist, HIM revenue cycle auditor, compliance auditor, ICD-10 educator, coding trainer, HIM manager, coding manager, director of coding, or vice president of coding.
2. Certified Inpatient Coder (CIC)
About: The CIC credential denotes one’s expertise in assigning accurate ICD-10 medical codes for diagnoses and procedures performed in the inpatient setting.
Who should have it: Consider this credential if you’ve met certain eligibility requirements and seek career advancement into many of the same inpatient positions listed above for the CCS certification.
Outpatient-specific coding credentials
1. Certified Coding Specialist—Physician-based (CCS-P)
About: The CCS-P credential denotes one’s in-depth knowledge of the CPT coding system as well as one’s familiarity with the ICD-10-CM and HCPCS Level II coding systems used in physician-based settings such as physician offices, group practices, multi-specialty clinics, or specialty centers.
Who should have it: Consider this certification if you’ve met certain eligibility requirements and would like to specialize in physician-based coding (office or outpatient facility setting).
2. Certified Professional Coder (CPC)
About: The CPC credential denotes one’s proficiency in coding for physician and other healthcare provider services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine.
Who should have it: Consider this certification if you have at least two years of coding experience and would like to work in an office setting as a professional coder, auditor, or coding manager.
3. Certified Outpatient Coder (COC)
About: The COC credential denotes one’s proficiency in assigning accurate medical codes for diagnoses, procedures, and services performed in the outpatient setting (i.e., emergency department, outpatient clinic, same-day surgery center, diagnostic testing center, or outpatient therapy facility).
Who should have it: Consider this credential if you have at least two years of coding experience and would like to work in an outpatient hospital/facility department or ambulatory surgery center.
4. Specialty medical coding certification
About: Specialty coding credentials denote one’s superior level of coding expertise in a particular specialty.
Who should have them: Consider one or more of these credentials if you’d like to work as a professional coder or auditor in a specialty physician practice setting.
Other coding credentials
1. Certified Professional Coder—Payer (CPC-P)
About: The CPC-P credential denotes one’s mastery of coding guidelines and reimbursement methodologies for all types of services from the payer’s perspective.
Who should have it: Consider this credential if you have at least two years of coding experience and would like to work in a payer environment as a claims reviewer, utilization manager, auditor, benefits administrator, billing service provider, provider relations representative, contracting representative, professional coder, compliance auditor, or customer service staff member.
Data analysis credentials
1. Certified Health Data Analyst (CHDA)
About: The CHDA credential denotes one’s ability to acquire, manage, analyze, interpret, and transform healthcare data into accurate, consistent, and timely information.
Who should have it: Consider this credential if you already have another HIM certification or baccalaureate degree as well as three years of healthcare data experience and would like to work in positions such as data integrity analyst, mapping specialist, or a whole host of others. Those with a master’s in HIM or health informatics from an accredited school as well as those with a master’s degree (or higher) and one year of healthcare data experience may also apply.
1. Certified in Healthcare Privacy and Security (CHPS)
About: The CHPS credential denotes one’s competence in designing, implementing, and administering comprehensive privacy and security protection programs in all types of healthcare organizations.
Who should have it: Consider this credential if you have healthcare experience and a minimum of an associate’s degree and would like to work in positions such as information security manager or privacy officer.
1. Certified Documentation Improvement Practitioner (CDIP)
About: The CDIP credential denotes one’s mastery of capturing documentation necessary to fully communicate patients’ health status and conditions.
Who should have it: Consider this credential if you already have a clinical, coding, or HIM certification and at least two years’ experience in CDI and would like to work as a CDI specialist, CDI trainer, or CDI consultant. Those with an associate’s degree or higher and three years of experience in CDI may also apply.
2. Certified Clinical Documentation Specialist (CCDS)
About: The CCDS credential denotes one’s competency in healthcare and coding regulations; anatomy, physiology, pharmacology, and pathophysiology; proficiency in medical record review; communication and physician query techniques; CMS quality programs and reportable diagnoses that impact quality metrics, and data mining and reporting functions.
Who should have it: Consider this credential if you’re currently employed as either a concurrent or retrospective CDI specialist and meet certain educational and experience standards.
1. Certified Healthcare Technology Specialist (CHTS)
About: The CHTS credential denotes proficiency in certain health IT workforce roles integral to the implementation and management of electronic health information.
Who should have it: Consider this credential if you have some health IT experience and would like to work in positions such as EHR implementation specialist, implementation support specialist, or Meaningful Use specialist.
Editor’s note: visit the AAPC’s website for more information about credentials for medical billing, auditing, compliance, and practice management. Other HIM professionals may be interested in pursuing credentials related to health information technology, health informatics, project management, and a variety of other areas of specialization.