Coder staffing has hit the proverbial brick wall. With thousands of coders consumed by ICD-10 training and thousands more actively involved in dual coding, clinical documentation improvement efforts, and end-to-end ICD-10 testing, hospitals and outsourced coding firms are focusing intently on coder supply, capacity, and development.

Everyone is searching for new ways to solve the coder talent shortage and meet ongoing coding demands.

Like finding four-leaf clovers, the chances of hiring trained, credentialed, and experienced coders in 2014 are extremely poor. New approaches are needed to solve health information management’s (HIM’s) age-old problem: a lack of available skilled talent.

Here are six observations from the trenches:

  1. The industry is thousands of coders shy of the figure necessary to fully support the transition to ICD-10 before, during, and after Oct. 1, 2014.

  2. Demand has been slowly increasing during the last 90 days and will skyrocket in the fourth quarter of 2014.

  3. Hospitals have already announced moratoriums on staff PTO during the fourth quarter of 2014.

  4. Medical transcriptionist (MT) positions are on the decline. MTs are seeking new career paths.

  5. The U.S. government is encouraging employers to implement registered apprenticeship programs, with particular emphasis on the hiring of military veterans.

  6. Partnerships with offshore coding firms are quickly becoming a best practice for strategic outsourced coding companies looking to build a safety net for their most valued clients.

Given the above facts, it’s time to get serious and apply innovative approaches to grow the coder workforce.

Transition MTs to Coders

Coding may be a good fit for MTs facing a bleak job forecast and fewer employment opportunities. When comparing the professions, it becomes clear that there are many similarities. Both groups need to have a solid understanding of medical terminology, anatomy and physiology, pharmacology, and pathophysiology. Seeds for growing this knowledge in preparation for ICD-10 coding have already been planted.

Additional training focused solely on ICD-10 coding rounds out the MT candidate and readies him or her for the transition to medical record coder. The next step is to understand the makeup, or internal DNA, of an ICD-10 coder and then use this information to identify ideal candidates from the MT pool. Key strengths to look for include:

  • Ability to abstract information quickly and accurately.

  • Knowledge of the medical record and where to find specific types of information.

  • Ability to navigate through electronic documents/screens/systems.

  • An affinity for and interest in research: solving mysteries and finding answers.

The American Health Information Management Association (AHIMA) is encouraging MT professionals to consider coding careers. Training programs to transition MTs to coding have been established and are growing in popularity. AHIMA’s CCA and CCS programs capitalize on the baseline biomedical knowledge of MTs and facilitate their entry into the job market.

Consider Hiring a Veteran

According to the U.S. Department of Labor, the military discharges 160,000 active service members and 110,000 reserve and National Guard members annually. About 32,000 of these veterans will join the ranks of the nearly 1 million veterans already unemployed.

A simple Google search for hiring U.S. veterans leads you to a variety of organizations dedicated to placing members of the military and their families, including veterans with healthcare backgrounds and experience.

Similar to the list of MT qualities identified above, medical terminology, anatomy and physiology, and pathophysiology knowledge is common among this specific workforce. The registered apprenticeship program is supported by AHIMA, and TrustHCS will be an early adopter.

Let Go of Expectations: Get Growing

Transitioning MTs or hiring veterans requires a shift in HIM mindset and human resources expectations. As an industry, it is time to accept that “unseasoned” coders will come on board to code. Requirements for three-plus years of coding experience are no longer realistic or achievable.

Although new coders are inexperienced, many are avid learners and very ready for mentoring and professional development. Hospitals and outsourced companies must commit to developing new coders and will need to increase their internal compliance monitoring and continuing education efforts. Quality from new coders will be comparable to that of their more experienced peers if hospitals and agencies invest in monitoring, education, and mentoring.

Get ready. Get set. Get growing.

About the Author

Torrey Barnhouse is the founder and president of TrustHCS, a firm dedicated to serving the coding, auditing, ICD-10 preparation, clinical documentation, and revenue integrity needs of healthcare organizations. Currently, Torrey serves on the AHIMA Foundation Board and the Remington College HIM National Advisory Board. He is a national speaker and author on a number of industry-related topics. He holds a bachelor’s degree in psychology from Abilene Christian University.

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