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June 2017

Evolving Education: Credentials — Valuable or Alphabet Soup?
By Valerie McCleary, MS, RHIA, CCS
For The Record
Vol. 29 No. 6 P. 5

Is it taking more time to complete your signature these days? What once was a quick, routine jaunt with a pen now takes a bit more time to complete. It could be because rapidly evolving technological advances have transformed the HIM profession into a diversified workforce with specialized skill sets.

As a result, it's becoming commonplace to see a long list of specialty credentials following an HIM professional's name. In today's health care workplace, is a college degree and a single generalist credential, such as the RHIT or RHIA, enough? Are numerous credentials really advantageous? Is one being pretentious, unfocused, and overzealous by listing a host of credentials, especially when some of those are not readily familiar to the average HIM professional?

What Are Professional Credentials?
In Health Information Management Technology: An Applied Approach, Laurie A. Rinehart-Thompson, JD, RHIA, CHP, FAHIMA, explains that certifications are awarded by a private entity recognizing an achieved "level of knowledge, competencies, and skills." Credentials, which are earned by passing a certification exam, demonstrate that an individual has achieved the professional standards of excellence set by a national, state, or local organization.

For individuals, earning a highly regarded credential may be a more attractive, less expensive, and less time-intensive alternative to returning to college to earn an additional degree. A credentialed employee may earn a higher salary than a noncredentialed colleague. Being credentialed can translate to a higher starting salary, while earning a credential on the job can result in a pay increase.

According to Everblue, "Professional certification can lead to salary increases of $5,000—upward of $20,000 annually." More job opportunities and greater job security—especially if the position requires a unique credential—are other perks associated with being credentialed.

Increasingly, the health care industry is viewing credentials as a requirement for employment. A credential can help ensure candidates are a match for the available position, resulting in reduced turnover costs. Credentials serve as confirmation that individuals are competent, motivated, and qualified as an expert in their specialty. It is likely they will enhance work quality and promote safety practices within their realm of expertise.

According to the American Healthcare Documentation Professionals Group, "The purpose of a credential certificate in any profession is to both protect the public and to guarantee that a person who holds the credential has met a minimum standard for professional and ethical standards." Credentialed individuals are aware of and compliant with standards, current laws, and industry changes, and possess the skills to effectively perform the job.

It takes well-trained professionals to capably fill HIM positions. Possessing credentials related to those job responsibilities is an asset, serving as reassurance that complicated, difficult tasks will be handled adroitly. Consider some of the following criteria HIM professionals must satisfy:

• Protecting patient privacy and security is paramount.

• Documentation standards must be met.

• Coding must be correct to receive accurate reimbursement.

• Proper release of information is essential.

• User-friendly electronic record technologies must be developed to meet established standards.

Credentialed individuals are respected by colleagues as HIM subject matter experts based on their knowledge, skills, and abilities. They can be relied upon for problem-solving advice, contributing to the development of new programs, providing expert internal and external education presentations, and creating subject matter information for marketing materials and other organizational needs.

With credentialed staff on hand, patients can be confident that caregivers have been adequately tested and deemed qualified and competent in their area of excellence. In the case of HIM, patient contact usually takes place when copies of medical records are requested or a transfer of protected health information is in order. Managed by credentialed HIM professionals, the release of information process is conducted expeditiously, securely, and confidentially according to policies, procedures, and regulations.

Credential Types
According to Mary Smolenski, former director of certification services at the American Nurses Credentialing Center, there are six types of credentials to be listed in the following order:

• an educational degree such as a BS, MS, or PhD (There has been debate about whether degrees should be listed starting at the master's level and higher.);

• licensure such as an LPN or RN based on successfully passing a national licensure exam (there is no licensure available for the HIM profession);

• a state designation or requirement to practice at a more advanced level. It may include advanced education, specific course work, or experience (This also does not pertain to HIM.);

• a national certification such as those offered by AHIMA and AAPC;

• awards or honors, including a fellowship identifying outstanding service or accomplishments in the profession (eg, FAHIMA); and

• other certifications based on additional skills.

How Are Certification Exams Developed?
Standardized exams offered by certifying organizations are available to individuals meeting eligibility criteria. Subject matter experts carefully craft exams to apply evidence-based practices and encompass weighted domains with preset levels of difficulty. An in-depth job analysis is conducted for each competency within the domains.

An individual's capability is tested for thorough knowledge of all aspects of the profession. A higher percentage of questions appears for the more critical competencies. Guidebooks outline the certification exam process, note fees, list test sites, identify available study resources, and provide answers to frequently asked questions.

Credential Use
To get the most value out of credentials, tailor résumés to include only those relevant to the position. Include work experience and professional accomplishments to justify the importance of each credential listed.

Candidates with many credentials should list the two most relevant after their name and the others in a certification section on the résumé. Additional credentials can be listed on sites such as LinkedIn and noted when posting a résumé on job sites such as AHIMA's Job Bank and HIMSS' Job Mine.

Determine how wide the job search will be when casting the net. Listing relevant credentials can narrow employment opportunities to those requiring specific credentials. Conversely, omitting credentials may open the door to more diverse opportunities. In general, HIM professionals are finding themselves in new roles by expanding their horizons and job outlook.

Credentialing Organizations
Numerous organizations offer health information-related certifications, including the following (certification and renewal fees apply; continuing education is a requirement):

AHIMA offers the RHIT and RHIA credentials, which have long served as the gateway into the HIM profession. Other AHIMA credentials are designed to spotlight specialty areas. HIM education programs have the option to incorporate specialty learning tracks, enabling students to earn a second credential in addition to the RHIT or RHIA.

Some RHIT/RHIA certified HIM professionals maintain their coding skills after earning their degrees and entering the job market. The choice whether to keep their coding skills up to date usually depends on the job. AHIMA offers an array of coding credentials, most of which require an annual assessment.

AAPC, in addition to its basic credentials, features 22 specialty coding credentials. The organization also offers credentials for medical billing, medical auditing, medical compliance, practice manager, and instructor certification.

HIMSS' go-to credentials are the Certified Associate in Health Information and Management Systems for emerging professionals and the Certified Professional in Health Information and Management Systems for the more experienced.

The National Healthcareer Association provides the Electronic Health Record Specialist and Billing and Coding Specialist credentials.

Health IT Certification offers four credentials, including the Certified Professional in Health Information Technology, for those seeking expert status in EHR and health information exchange practices.

The International Information System Security Certification Consortium, or (ISC)2, offers the Certified Information Systems Security Professional credential with several areas of concentration, including architecture, engineering, and management. Seven other certifications are available, all of which relate to safety and cybersecurity.

The Compliance Certification Board features five certifications related to health care compliance, including the Certified Compliance and Ethics Professional.

The International Association of Privacy Professionals delivers three credentials, including the Certified Information Privacy Professional certification featuring five concentrations.

The Project Management Institute offers the Project Management Professional certification for project managers.

Display the Competitive Edge
The job market has become increasingly competitive as health care professionals seek positions that do not involve direct patient care. Some are even infiltrating areas where HIM professionals previously reigned. As a result, a credential can make HIM professionals stand out among other applicants. For example, a candidate with RHIA and Certified Documentation Improvement Practitioner credentials may have an edge over an RN for a clinical documentation improvement position.

Continuing Education
Credential maintenance is tied to continuing, lifelong professional education requirements. In any profession, ensuring credentialed employees remain current in best practices is essential. This requirement can be fulfilled by attending national, state, or regional conferences, completing specified training, engaging in webinars, earning additional college credits, or participating in other activities approved by the accrediting organization. By doing so, the individual's credential is renewed for a specified period of time.

Employees are often expected to remain credentialed, especially if it is a job requirement. The good news is that some employers allocate budget funds to assist with continuing education.

Bottom Line
More than ever, health care organizations are having their feet held to the fire to protect the privacy, security, and welfare of patients and their health information. Multiple HIM credentials provide added value for employees, employers, coworkers, colleagues, consumers, and patients. Numerous credentials are only considered alphabet soup if the designations do not apply to the job being performed and/or the employee does not provide the expected level of work performance based on their training and credentials. The more credentials that apply to the position, the more likely an individual is competent in multiple aspects of HIM.

So if it takes a little longer to "sign" your name, just think of the value of those few extra strokes.

— Valerie McCleary, MS, RHIA, CCS, has enjoyed a varied career serving in academia as an online program director, assistant professor, and adjunct instructor, and in health care as an HIM director and consultant with extensive knowledge of best practices in all aspects of HIM management and health informatics.