How to Get Health Care Compliance Certification

Health care compliance is a complex and highly regulated field Organizations handling protected health information and delivering patient care must follow strict rules and standards Having certified compliance professionals on staff can help health care entities mitigate risks, avoid penalties, and operate effectively within the guidelines.

If you are interested in advancing or starting a career in health care compliance, getting certified is an important step. Professional compliance certifications demonstrate your knowledge and skills in this niche profession. They can improve job prospects and lead to career advancement.

This guide will explain how to get certified in health care compliance through examination, continuing education, and experience. We’ll cover the major certifying bodies, certification options, eligibility, steps to get certified, and the benefits certification provides.

Overview of Health Care Compliance Certification

Several organizations offer professional certification programs for compliance officers and specialists in the health care industry Each has its own focus area, requirements, exams, and credentials.

The two most widely recognized are:

• Certified in Healthcare Compliance (CHC) – Offered by the Compliance Certification Board (CCB), a division of the Health Care Compliance Association (HCCA). The CHC certification is broad-based for professionals in all health care compliance domains.

• Certified Compliance & Ethics Professional (CCEP) – Granted by the Society of Corporate Compliance and Ethics (SCCE). The CCEP covers general ethics and compliance across multiple industries, including health care.

Other programs certify specialized compliance skills and knowledge such as auditing, HIPAA, privacy, clinical documentation, and revenue cycle management. Overall, certifications help demonstrate expertise and commitment to the field. Employers may require or prefer candidates to have compliance certifications.

Let’s look closer at the main steps to earning these professional credentials.

Meet Education and Work Experience Requirements

Each health care compliance certification program sets education and work experience eligibility prerequisites. This ensures candidates have the proper foundation and background knowledge needed to understand regulations, perform compliance duties, and pass the exams.

Typical eligibility requirements include:

• College education – A bachelor’s degree or higher from an accredited college or university is commonly required. Specific majors such as health care, business, or law are preferred but not always mandatory.

• Work experience – Most certifications need 1-2 years of full time professional compliance work experience. Auditing, privacy, documentation, coding, and other specialized experience may also qualify. Some programs allow compliance internships to substitute for a portion of the required experience.

• Continuing education – Certification renewals require ongoing compliance education such as conferences, training courses, webinars, publications, and other activities. A certain number of credits are needed every 1-2 years to maintain credentials.

Review the eligibility criteria carefully for the specific certification you plan to pursue. Educational waivers are sometimes available for substitution of additional experience.

Choose the Right Certification Program

With your background, select a certification that matches your profession and interests. Consider factors like your current and desired job role, industry segment, compliance domain expertise, career goals, and employer needs.

Here are some top options with key details:

• CHC – Broad certification ideal for general compliance officers in health care entities. Focuses on regulations for care delivery, billing, HIPAA, fraud, audits, and programs. Offered by HCCA.

• CCEP – Cross-industry credential with ethics, laws, policies, and programs content. Good for corporate compliance leaders overseeing multiple areas. Offered by SCCE.

• CCS-P – Specialty coding credential for professionals handling ICD diagnosis and CPT procedure coding. Offered by AHIMA.

• RHIA – Hospital and provider coders/auditors managing patient records and data. Offered by AHIMA.

• CHPC – Privacy officers developing safeguards and controls for PHI. Offered by CCB.

• CHRC – Clinical research compliance at pharmaceutical and device companies. Offered by CCB.

Select the right certification for your specific compliance responsibilities and career path. Your employer may also mandate or prefer certain credentials.

Prepare for the Certification Exam

Once your eligibility is approved, you can register for the certification exam. Thorough preparation is crucial for success. Here are some tips:

• Closely review the exam content outline and knowledge domains tested. Identify any weak areas to focus study.

• Take advantage of study guides, practice questions, and exam prep courses offered by the certifying body. These directly cover material likely to appear on the test.

• Read core compliance references like HCCA’s Complete Healthcare Compliance Manual and study government regulations in your domain.

• Attend compliance webinars, conferences, and in-person training opportunities. These help reinforce knowledge.

• Study real-world cases and examples published by DOJ, OIG, and professional associations to understand how regulations apply.

• Join a study group with colleagues or enroll in a compliance exam prep course for coaching and peer support.

With diligent preparation, you can pass the exam and achieve your compliance certification goal.

Schedule and Take the Exam

Once you feel ready, register for an upcoming exam date and location convenient for you. Most certification exams are offered year round on computer at authorized testing centers. Some allow online proctored testing from home.

Here’s what to expect on exam day:

• Arrive early – Leave time for check-in procedures to avoid feeling rushed. Get settled before your scheduled start time.

• What’s allowed – Expect to show ID, provide fingerprints, have a photo taken, and store personal items in a locker. Calculators and writing implements may be permitted.

• Testing format – Questions can be multiple choice, multi-select, matching, true/false, fill in the blank, or hot spot. There may be drag and drop, sorting, and highlighting tasks.

• Timing – Certification exams are typically timed at 2-3 hours and include 125-200 questions. Pace yourself carefully to complete all items.

• Results – Passing scores vary but usually require 70%+ correct answers. Results are given same day or within a few weeks by email or online account.

If you pass the exam, congratulations! You’ve earned the right to use the certification credential and will receive a certificate. Renewal will eventually be required through CEU credits. If you don’t pass, simply study your weak areas more and schedule a retake.

Leverage Certification to Advance Your Career

Once certified, take steps to get the most career benefit from your new credentials:

• Add it to your resume – Prominently display your new certification and credential initials after your name. This communicates your expertise.

• Update profiles – Add the certification to LinkedIn, bios, email signatures, and anywhere that promotes your qualifications.

• Get a raise/promotion – Use the certification to support asking your manager for an increased salary or elevated role to match your new skills.

• Find new opportunities – For those seeking a new job, compliance certifications can improve prospects and give you an edge over other candidates.

• Maintain renewal – Stay current by meeting CEU requirements and renewing the certification every 1-2 years. This shows ongoing learning.

The right health care compliance certification can enhance your skills, get noticed, open career doors, and lead to bigger and better opportunities. Earning a respected credential is a worth while investment in your professional future.

With compliance rules constantly evolving, certified professionals are in high demand in health care. Investing time to earn certification credentials can boost your expertise, career prospects, and potential earnings.

Use the steps in this guide to select the ideal certification for your background and goals. Then prepare thoroughly to pass the exam. Once certified, maintain renewal while leveraging the credential to demonstrate your value.

Health care compliance certification requires commitment but delivers immense benefits for your career long-term. The respect, opportunities and rewards are well worth the effort to become certified.