Healthcare Administration and IT Certifications
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The United States healthcare industry represents a robust portion of the American economy. In 2021, this sector of the American economy represented nearly one-fifth of the nation’s GDP. Significant demand for qualified healthcare professionals is anticipated in the coming years. Factors sustaining this demand include the continued development of innovative technologies and standards of practice within medicine, breakthroughs in medical knowledge, and the demographic shift towards a more elderly population.
The field of healthcare administration can prove a rewarding career for those interested in operations and finance within the fields of medicine and public health. The US Bureau of Labor Statistics (BLS 2023) offers a very encouraging job outlook for this field. Between 2022 and 2032, employment of medical and health service management professionals is predicted to grow by an impressive 28 percent. This is much faster than the expected growth rate averaged across all occupations during the same period (3 percent). The median annual wage for medical and health services managers was $104,830 in May 2022. Highly experienced individuals working in a high-volume healthcare setting can easily earn much higher than this median salary.
The field of healthcare administration stands at the intersection of technology, policy, business, and medicine. Medical and health services managers plan, direct, and coordinate the business activities of healthcare providers. They may also be responsible for supervising hospital personnel to ensure regulatory compliance. Such professionals customarily work in healthcare facilities such as hospitals, nursing homes, and group medical practices. Most such individuals work full-time, and some roles may require availability beyond forty hours per week.
A career in healthcare administration typically requires a bachelor’s degree from an accredited institution that provides both the industry knowledge and training necessary to succeed in entry-level management positions. Those seeking high-level executive positions may go on to complete an advanced degree. Coursework typically includes basic business skills, human resource management, and an orientation to insurance and related reimbursement processes. In addition to an academic degree, another way to enhance qualifications is via certification. Certification is typically far less time and money-intensive than completing an academic degree.
Certification is a time-efficient way to answer the omnipresent challenge of maintaining skills in a profession as complex and ever-evolving as medicine and healthcare. Professionals holding substantial work and family commitments often find it challenging to embark on something as demanding as an academic degree. Certification programs are generally minor commitments of time and energy and are often designed to accommodate the schedule needs of busy individuals. Certifications can also be critical because they are occasionally an integral aspect of the process for securing licensure. Though licensure is often optional for many management jobs, some must be licensed if they work in certain settings, such as nursing care and assisted living facilities.
There exists a wide variety of certification programs. Such variety is based on the recognition that required expertise within the field of healthcare administration can significantly vary due to the needs and common issues associated with caring for patient populations. For example, a healthcare administration professional working in a nursing home setting may need to have significantly more knowledge of certain forms of insurance coverage commonly used by elderly populations than someone who works in a private medical practice for a primarily middle-aged, relatively healthy patient population.
Though several healthcare administration jobs may not require certification, it is nonetheless wise to attain strongly recommended certifications as they provide professionals the opportunity to maintain current skills and, when completed, also demonstrate a commitment to competence and excellence. Voluntary certification thus increases a candidate’s appeal in the job market.
This article focuses on the top certifying agencies operating within the healthcare administration sector, the certifications they offer, and how they may appeal to healthcare professionals.
American Health Information Management Association (AHIMA)
The American Health Information Management Association (AHIMA) is responsible for the voluntary certification of healthcare administrators. AHIMA is a global nonprofit association of health information (HI) professionals dedicated to empowering people to impact health and healthcare outcomes positively. AHIMA seeks to fulfill its mission by applying its core values of integrity, bold action, and inclusivity. AHIMA member leaders work at the intersection of healthcare, technology, and business and can be found working worldwide.
Certified Professional in Health Information Technology (CPHIT) Certification
The CPHIT certification program recognizes professionals who have critical knowledge and skills within the health information technology field. Certification applicants usually need approximately six months to complete this certification process. This process consists of preparing for and passing the exam, completing any required continuing education units, and submitting all necessary application materials and related documents. Certification applicants must:
- Be registered with AHIMA
- Have at least two years of experience working with health information technology systems
- Have a bachelor’s degree or higher in a related field
- Pass a certification examination. Exam topics include healthcare data standards, privacy and security, clinical decision support systems, and electronic health records
- Fully pay any professional membership, application and other applicable fees
Registered Health Information Administrator (RHIA) Certification
RHIAs are a critical connection between care providers, payers, and patients. An RHIA has expertise of the medical, administrative, ethical, and legal standards and requirements necessary to both deliver quality healthcare as well as ensure protection of patient privacy. RHIAs can be found in numerous settings such as hospitals, multispecialty and single-specialty physician practices, long-term care, mental health, and other care settings. Non-patient care settings where an RHIA may work include insurance companies, consulting services, government agencies, and pharmaceutical companies.
To take the RHIA exam, applicants must meet one of the following requirements:
- Have a baccalaureate-level degree that fulfills the academic requirements of a Commission on Accreditation for Health Informatics and Information Management Education (CAHIM) accredited Health Information Management program (HIM)
- Have a master’s degree whose academic requirements meet those of a CAHIM-accredited program
- Complete the academic requirements of a CAHIM-accredited post-baccalaureate program
- Graduate from an HIM program approved by a foreign association with a reciprocity agreement with AHIMA
AHIMA Certification Testing
AHIMA certification requires successfully passing the exam that corresponds to the desired certification. Exam fees range between $199 to $399 and depend both upon membership status and which exam is taken.
Applicants must submit materials, including documentation of certifications earned, education, or work experience, to establish eligibility. AHIMA exams contain various questions or item types and require knowledge, skills, and/or experience to pass them successfully. Each exam includes scored questions and pretest questions randomly distributed throughout the exam.
AHIMA Certification Renewal
Certification holders are required to pay their recertification fees annually. They also must complete between 20 to 50 continuing education units every two years. The exact number of required CEUs ultimately depends on the number and type of certifications held.
American Association of Healthcare Administrative Management (AAHAM)
The American Association of Healthcare Administrative Management (AAHAM) is the premier professional organization in healthcare administrative management. It is the only national organization explicitly dedicated to the revenue cycle. AAHAM seeks to serve several purposes. It is a resource center for information, education and advocacy in reimbursement, admitting and registration, data management, medical records, and patient relations. AAHAM also supports the professional development of its members via publications, conferences, professional certification, and professional networking opportunities.
Finally, AAHAM seeks to actively represent the healthcare administrative management professional workforce through legislative and regulatory monitoring and collaboration with industry groups.
Certified Revenue Cycle Executive (CRCE) Certification
The CRCE certification is designed to aid senior/executive leaders strategically manage their businesses. Certification demonstrates professionals have mastered the art of revenue cycle management, are recognized as leaders and role models in the revenue cycle industry, and are highly competitive candidates for career advancement. The certification exam covers patient access, billing, credit and collections, and revenue cycle management. To become CRCE certified, an applicant must:
- Be a national AAHAM member in good standing
- Have a minimum of four years of experience in a healthcare-related field; a two-year associate degree or a degree from an accredited university or college can be substituted for two years of experience
- Pass all four sections of the exam with a minimum score of 70 percent
Certified Revenue Cycle Professional (CRCP) Certification
The CRCP certification is designed specifically for supervisors and managers in the revenue cycle industry. Though not a prerequisite for executive-level certification, CRCP certification is nonetheless designed as a step toward executive certification for those interested in achieving this level of advancement. The certification exam covers patient access, billing, credit and collections, and revenue cycle management. To become CRCP certified, an applicant must:
- Be a national AAHAM member in good standing
- Have at least two years of experience in a healthcare-related field or a two-year associate degree or a degree from an accredited university or college; those who qualify using education must submit a transcript as part of their application.
- Pass all four sections of the exam with a minimum score of 70 percent
Certified Revenue Integrity Professional (CRIP) Certification
CRIP certification is designed for revenue cycle industry professionals seeking to ensure their facilities effectively manage their charge master as well as appropriately bill and document for all rendered patient services. Certification recognizes an individual as having an in-depth, working knowledge of various revenue cycle areas and skill sets necessary to increase revenue and reimbursement.
The four-hour online proctored certification exam tests for competencies in four core areas. These areas are overall review of charge capture, ancillary services, surgical services and procedures, and recurring outpatients and clinical services. The only eligibility requirement is an applicant must be a member of the national organization in good standing. As with other AAHAM certifications, individuals must pass all exam sections with a minimum score of 70 percent to earn their certification.
AAHAM Certification Testing
AAHAM offers a variety of supportive resources for those preparing for a certification exam. Applicants can retake an exam if they fail one or more sections. Those who fail three or four sections of the exam must retake the entire exam. Exam retakes for failed sections must be done within twelve months from the initial exam date. In cases of section retakes, the test taker is responsible for arranging both the location and proctor for the exam. A maximum of two retakes are allowed. Those who still fail to pass the needed sections must take the full exam within the next available testing period.
AHIMA Certification Renewal
Eligibility for recertification is contingent on fulfilling several requirements. The specifics of these requirements do not vary much among different certifications. Generally speaking, to be eligible for recertification, a person must:
- Be a member in good standing no later than January 31st of each calendar year
- Have completed a minimum number of continuing education units (CEUs) under the specific requirements of the desired (re-)certification
- Submit documentation of CEUs such that they are received and recorded by the national AAHAM office in a sufficiently timely manner
American Academy of Professional Coders (AAPC)
The American Academy of Professional Coders (AAPC) was founded in 1988. Its focus is to provide education and certification to coders in physician-based settings such as group practices and specialty centers. AAPC is the nation’s most extensive education and credentialing organization for various professionals, including medical coders, billers, auditors, practice managers, and more. A review of the organization’s website reveals it offers a very large number of certification programs in topics including coding, billing, auditing, practice management, compliance, and documentation.
As a prerequisite for membership, an AAPC member must abide by the AAPC Code of Ethics. AAPC works to discover, develop, and provide innovative products, services, and solutions to meet the needs of the healthcare industry. AAPC offers several certifications as well as a variety of training courses and workshops designed to help its members advance their education and careers.
Certified Professional Compliance Officer (CPCO) Certification
Healthcare administrators who wish to stand out as compliance experts can do so with the CPCO credential. CPCO certification indicates a person has competence in the key requirements needed to effectively develop, implement, and monitor a healthcare compliance program.
Eligible applicants must:
- Be a current AAPC member
- Pass a four-hour, 100 multiple-choice question exam covering numerous compliance topics
- AAPC strongly recommends candidates have at least two years of experience working in compliance programs and at least an associate’s degree in a healthcare-related field
- Fully pay any professional membership, application, and other applicable fees
Certified Physician Practice Manager (CPPM) Certification
The CPPM certificate attests to the skills of those who work as a physician practice manager. Such managers often have responsibilities over several focus areas, including revenue cycle, compliance regulations, human resources, health information, and general business operations. Experienced practice managers may find still more opportunities for advancement by completing this certification.
Eligible applicants must:
- Be a current AAPC member
- Pass a 135 multiple-choice question exam; this exam is designed for individuals with significant physician practice management experience and is not advised that managers with minimal experience take this exam without first doing adequate preparation
- Fully pay any professional membership, application, and other applicable fees
American Academy of Professional Coders Certification Program (AAPC-CP)
THE AAPC-CP program is a professional certification program that recognizes individuals who possess a high level of expertise in medical coding.
To become certified, applicants must meet these requirements:
- Have at least two years of coding experience or one year of coding experience plus a coding certificate from an accredited institution
- Pass an exam that covers topics such as anatomy and physiology, medical terminology, coding systems, and reimbursement principles; the exam has 150 multiple-choice questions and takes approximately three hours to complete
- Fully pay any professional membership, application, and other applicable fees
AAPC Certification Testing
Each certification has its unique test. Candidates are required to pass the exam for each certification they are seeking. Individual examination attempts cost up to $399, with additional attempts often costing a smaller per-attempt rate. For example, a single attempt of the CPCO exam costs $399, while two attempts cost a total of $499.
Applicants must register for their exam three weeks before their desired examination date. AAPC notes that students who train with AAPC are three times more likely to pass the certification exam.
AAPC Certification Renewal
To maintain certification, professionals must maintain current AAPC membership. An annual membership costs $205, while current students are eligible for a $140 membership. Every two years, certification holders must submit proof of completion of the minimum number of continuing education units necessary for re-certification. The actual number of required CEUs varies by both certification and the total number of certifications held. If more than one certification is held, the number of required units increases, up to a possible total of 52 for those who hold five or more certifications.
American College of Healthcare Executives (ACHE)
The American College of Healthcare Executives (ACHE) is an international society of more than 48,000 healthcare executives focused on leadership in hospitals, healthcare systems and other healthcare organizations. ACHE seeks to be the preeminent professional society for healthcare executive leadership. It fulfills its mission of advancing both the careers of its membership as well as healthcare leadership excellence through its network of member chapters as well as its magazine, Healthcare Executive. ACHE is known for its career development and public policy programs.
Fellow of the American College of Healthcare Executives (ACHE)
ACHE recognizes healthcare administrators who have achieved a high professional achievement in healthcare management via the Fellow of the American College of Healthcare Executives (FACHE) credential. This credential indicates recipients are known for their expertise, experience, and commitment to professional development and continuing education. Earning the FACHE credential depends on several factors, including academic preparation, ACHE tenure, community and civic involvement, healthcare management experience, and more.
To secure this certification, applicants must:
- Be an ACHE member for at least three years
- Be a graduate of a master’s or other advanced degree program
- Hold a healthcare management position and have at least two years of healthcare management experience
- Submit at least three references from current fellows
- Have at least 36 hours of healthcare management continuing education units (CEUs) during the three years preceding becoming a fellow; 12 unit hours must be ACHE face-to-face education participation in two healthcare-related and two community/civic activities within the past three years
- Fully pay any professional membership, application, and other applicable fees
- Submit a Fellow application
- Successfully pass the Board of Governors Exam; the exam consists of 230 questions (30 are pretest questions), and it must be completed within six hours; the exam consists of questions focused on ten knowledge areas identified by ACHE as pivotal for success in healthcare management
Certified Health Executive (CHE) Certification
The CHE certification recognizes healthcare executives who demonstrate excellence in their field as evidenced by their education, experience, and commitment to ethical standards.
To be certified, applicants must:
- Have a minimum of five years of executive-level healthcare management experience
- Have demonstrated achievement in areas such as strategic planning, financial management, operations, quality improvement, and patient safety
- Pass the CHE certification exam; exam applicants generally need six to 12 months to complete CHE certification program requirements
- Fulfill any other requirements set forth by ACHE
- Fully pay any professional membership, application, and other applicable fees
American College of Healthcare Executives Certification Program (ACHE-CP)
The ACHE-CP is a professional certification for healthcare executives. This certification recognizes a professional has the knowledge and skills necessary to be a successful manager and leader in the healthcare industry. ACHE-CP applicants typically need six months to one year to complete the program and take the exam. To be certified, applicants must:
- Be members of ACHE
- Have at least five years of experience in a senior-level position within the healthcare industry or hold an advanced degree from an accredited college or university in a health services field
- Complete a professional development plan demonstrating their commitment to continuing professional development throughout their career
- Pass an examination that covers topics such as healthcare finance, strategic planning, operations management, quality improvement, human resources management, and other related topics; this three-hour exam consists of 150 multiple-choice questions.
- Fully pay any professional membership, application, and other applicable fees
ACHE Certification Testing
Each ACHE certification has its own test uniquely designed to test for a certain set of competencies. Candidates are required to pass the exam for each certification they are seeking. Examination registration fees vary according to the exam. For example, the FACHE credential exam has a registration fee of $200. The ACHE website offers resources to assist individuals with assessing their current competencies and preparing for their exam.
ACHE Certification Renewal
ACHE Fellows must recertify their FACHE certification every three years. The recertification application with payment is due between January 1 and December 31 of the year the certification expires. All requirements must be completed when the application is submitted.
Through December 31, 2023, applicants must demonstrate completion of 36 continuing education units (hours) of healthcare management-related continuing education within the last three years to secure recertification. These hours of healthcare management-related continuing education are composed of:
- A minimum of 12 hours of ACHE face-to-face education earned by participating in ACHE education events
- The remaining 24 hours may be additional ACHE face-to-face education hours or can be hours earned from other professional organizations
Beginning January 1, 2024, those seeking FACHE certification or recertification must meet slightly altered requirements.
