Recession or Not, Coder Shortages Persist

This time last year the Journal surveyed members on their top coding challenges. High on the list were staffing shortages, with respondents citing trouble finding qualified coders. This year the Journal again informally polled a group of members, this time focusing on the state of coder staffing.

The long-standing coding shortages weren’t magically solved in the past year. Only 60 percent of respondents to this year’s poll reported that their departments are completely staffed for all approved positions. About a quarter (23 percent) have coding positions that have been open for more than 3 months. The balance reported positions that have been open 3 months or less.

current staffing levels

A lack of qualified candidates appears to remain the root cause. The vast majority of respondents (46 percent) said their departments are short on coders due to a lack of qualified candidates in the market. Many respondents commented that candidates lack on-the-job experience.

A minimal number of respondents said their staffing shortages are the result of hiring freezes or layoffs. Layoffs were the cause of coder shortages in only 1 department.

Thirty-eight percent said they were under no restrictions on hiring for approved positions. Nearly half (48 percent) reported that their departments are able to recruit for open positions, though no others. The final 14 percent reported a complete freeze on hiring.

The lack of experienced candidates in the market is requiring organizations to be flexible, creative, and committed when filling positions. Respondents commented that their departments commit to training hires that lack experience, grow coders from within, and work with community colleges to boost the local pool of candidates.

The survey was conducted online June 29–July 12, with 95 responses.

33 Comments

  1. Why not hire new graduates that have the core education needed to be successful coders and who are often the most eager to work in coding, but who may not have tons of experience? I have my Associate’s in HIT and my RHIT certification but I don’t have prior on-the-job coding experience. I’ve been looking a coding job for over a year now. I can’t even land an interview. I have all this education and nowhere to apply it…and I KNOW that I am not alone! There are lots of people just like me, just waiting for a HIM manager to snatch us up. Hire us! Yeah, you’ll have to take the time to train us, but think of it like this…you can mold us into the coders you want us to be! And, you can probably pay us a whole lot less than a coder with several years of experience! That’s how you solve your coding shortage!!!

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  2. And so is the problem with the newly certified coding candidate. You can pass all the tests, get certified, but yet everyone still wants experience. It was my understanding that to pass the CCS it was recommended that one have 2+ yrs experience. One would assume that if you were able to pass such a test that you were indeed qualified for a position requiring 2+ years experience. I have been a medical transcriptionist for 18 years and it was this way then in medical transcription and has not changed, I was disappointed that medical coding was the same.

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  3. I AGREE WITH EVERYTHING NOTED ABOVE BUT I DO BELIEVE THAT WE HAS CODERS NEED TO HELP NEW CODERS AND TRAIN THE ONES FRESH OUT OF SCHOOL.

    THAT IS THE ONLY WAY WE ARE GOING TO GET MORE
    NEW CODERS.

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  4. Make sure the coding area is a friendly culture and the bullies in the office must repeat Harassment educational courses, even if the manager and supervisor argue over who will send this E Mail , which in my office both were afraid to do the right thing.

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  5. I looked for over a year. Applying for any thing I could, to get into any hospital. By the grace of G-d, Providence hired me. I enjoy where I work, and the people I work under. I feel the requirements need to be relaxed a bit to fill the deficiate not only from the employers side but also from the Credentialing entities.

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  6. I have many years experience as an acute care
    inpatient coder, plus I am a concurrent coder and I love it. I love the interaction between me and the physicians on the floors. I’m sorry
    all hospitals don’t have concurrent coders, most
    have nurses who unfortunately really don’t get
    coding or the reimbursement process. Managers
    you should seriously entertain the introduction
    of concurrent coders and watch your casemix increase considerably.

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  7. The POA requirements, MS_DRGs and RACs have added more stress and also it takes longer to code a chart now. We are supposedly fully staffed but we have too much to do. We are audited quarterly and our accuracy rates have gone down since we are asked to do so much. Then the director gets upset because we aren’t as accurate, yet she wants us to do more so the hospital gets paid.
    We need to have better mentoring of new coders and make it easier for them to enter the profession.

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  8. I agree I have a degree in Health Information Technology, and my R.H.I.T. certification, but I can’t not find a job… I have a wonderful work history just not as a coder. I am so eager to work for a hospital but no one wants someone with no experience…

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  9. I have had many years of inpatient coding and auditing experience. I am a Compliance Auditor and as I audit coders for compliance, I find it very evident when coders code from memory and chose not to use an encoder. This is because of their being pushed for productivity. Or I see evidence that coders choose a code without using all the facts that are documented. This scenario is my favorite because I actually give them my thought processes for reaching a code. This helps the young inexperienced coder to learn but I’m also rewarded by knowing I have added to someone’s knowledge base. My desire would be that all experienced coders take one person under their wings, whether it be chart by chart or by an occasional coding question as long as you make it an educational experience and not just give them a code. Thanks, Diann BS, RHIA, CCS

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  10. I also had difficulty finding a position as a new coder fresh out of school but with a CCA after my name. Had to apply to every hospital in a very large metropolitan area to just get 2 interviews. Thank goodness I had one manager who was willing to take a chance! I was an RN before and it is common practice for nurses whether new or experienced to receive several weeks to months of on the job training and mentoring. Don’t know why that is such a difficult concept for HIM.

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  11. A coder has to prove oneself when entering into the coding world. When given an interview be prepared to take a coding test on site with the coding book not the the encoder. If not offered a test request a test and you wlll know if the depatment is quality driven or productivity driven. No test no quality. If any of the new coders can they should try to shadow a Clincial Documentation Specialist.
    Remember coding supervisors just because a coder is experienced doesn’t mean your getting quality.

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  12. Perhaps the formal education curriculum needs to be revisited and reinvented to include actual hospital patient medical records that are deidentified. This would offer the student the opportunity to “get some real world experience” and relieve (not eliminate) the burden on the hospital HIM dept resources (or should I say lack of resources) available to “teach” coding on the job. Criteria related to the volume and “passing score” as well as complexity of these deidentified charts should be included in the class as well as productivity standards.

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  13. Where does a twenty year veteran in coding go for mentoring…AHIMA I don’t think so. I am sad that I will no longer be able to afford AHIMA anymore…never really much on coding anyway. Magazine got smaller and smaller. I truly feel sorry for new coders…coding is truly a thankless job and we will always be treated like clerical workers. What is a coder, it is one of the hospitals best kept secrets.

    Janis Hunter, CCS

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  14. It is unfortunate that facilities ask for experience rather than considering the knowledge and education of the new graduates, with credentials. It is only a matter of time, these graduates can be become efficient coders. Also, the facilities can give a period of time to prove their ability

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  15. We are willing to train an RHIT in coding. We are located in Tulsa, Oklahoma. Please call me at 918-388-5703 for details.
    Thank you, Kim Dryden,RHIA

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  16. I am very discouraged with the posts here (my reality appears to be shared) … I graduated from a medical billing and coding program (10k invested) with a 3.95 GPA and recently passed the AHIMA CCA exam. I have an incredible work history w/employer references, worked as an LPN for 15 years, work ethics beyond OCD levels and can’t get an interview; I don’t even get a phone call. I have sent out cover letters allowing the employer 6 weeks of my training as an externship (no pay/benefits) so that I can prove that I would be an asset. NOTHING! I live in Dallas, Texas (medical city) and I can’t get my foot in the door. I want to be a medical coder badly and with just a bit of training; I would probably be one of their best employees. If any of the experienced coders could share their stories on how they received their first job offer (and the route taken to get the interview), it would be greatly appreciated. Thank you all in advance from a newly certified coder.

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  17. I have worked very hard to obtain my degree in HIM from and accredited college and also obtain my RHIT. NO ONE will hire me because I do not have 2 to 3 years of experience. I feel like all my hard work has gone down the drain and it was for nothing!

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  18. I graduated in 2010 with my assoc. degree in HIT, and now have my RHIT certification, and 6.5 years of past valuable clinical health care experience. I CANNOT Find a job anywhere!!! I have had my resume evlauated by professionals and was told it was just find. I work on my interviewing skills, have taken pre-employment coding tests and passed very well and still have no job. AHIMA is a joke btw they do nothing to advocate for the new HIM graduate – just who do they think will be supporting their organization in the future?!?!?!? Not me that is for sure! What a waste of time and money!!! Coding shortage – some of these employers and healthcare organizations need to step up and start training new graduates and that is a simple solution to the coding shortage!

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  19. I have over 14 years experience in medical billing, 6 years experience as a coder, I am a certified and state licensed adjudicator, CPC and CPMA certified and working on CPCO in January. I cannot find a job. Every interview I get the first question is how much money do you want? I ask them right back how much do they think someone with my experience and credentials are worth and that we can negotiate the salary. I found out that the last two jobs I interviewed for the physicians ended up hiring someone with no certification for $12.00 an hour. I’m done with the provider’s side. I’m only applying to insurance companies from now on.

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  20. The catch-22 is still strong as ever. I was going to school in the medical transcription field before I said “forget it” and switched over to the coding side. Quite frankly, I have found its who you know just as much as what experience do you have. I am almost finished with my AAS in HIT. I have not even started looking for a position yet and I am already tired of it(catch-22). I promise, if I ever get a leg up in this field, I will create a medical coding company dedicated to the newly graduate. While I understand why one needs experience-obviously…..how can you get that experience if no one wants to even give you a little bit of their time to train you. I mean, there are so many benefits to training a new grad. Yes, it costs money to train, but think about it in the long run…..you will have an employee who knows how the company does things instead of them learning from being thrown to the wolves….

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  21. I was a Registered Nurse for 20 years. Due to staffing shortages and long hours I decided to take a course in Medical Coding at a local college. I completed the course and passed the CCA Exam through AHIMA in March 2012. I am currently looking for a job as an entry level coder but it seems that every jobs requires 1-5 years of experience to even be considered for the postion. This leaves me at a total loss. Where do I get the on the job training needed to apply for these jobs? Is anyone willing to help the new coders? Any help or ideas would be greatly appreciated.

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  22. As a director in an HIM department many of these posts are very concerning to me. My assistand director was hired straight out of school before she even passed her certification exam. My most recent transfer into the outpatient coding department was a clerk who decided to go back to school. She is training on the job while in school. So, for those of you who are discouraged, don’t loose hope. Some of us fully support hiring new grads. Perhaps you just aren’t looking in the right place. Tifton, Georgia

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  23. I have shelled out close to 7K to get this education and training and I am STILL looking for an entry level position. THEY DON’T WANT TO TRAIN PEOPLE. THAT IS WHY THERE IS A SHORTAGE! Illinois, home of AHIMA, I might add..is THE worst state for this. The problem is that there is nobody out there who wants to take novices under their wing and teach them like someone taught them years ago. They are either afraid to do it,or figure it’s not in their job description. I thought AHIMA’s bylaws stated that they were to encourage new members to pursue careers in this arena, but there are so many of us out here that are completely disheartened with the entire process, we are all ready to throw in the towel completely!

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  24. I can tell you why there is a shortage, overflow of new graduates that NO ONE is willing to hire. I have spent thousands on a degree, received my RHIT – only to find out this whole degree and certification is a scam. I am going back to school after three years of job searching and no luck.

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  25. I am a current student, who has been working in the field for a transcription company (not as a transcriptionist) but as account manager. I am finding out by attending meetings and simply talking with others that all of the comments here are correct; alot of places its who you know, although not really the best way to do it, hospitals are more particular because they NEVER close, they need their staffs to be already at the lerning curve or above it when they come in the door. I have found that maybe trying out coming into the field via a different entry port such as physician practices (smaller ones), vendor services associates (such as transcription & documentation services, etc mya help you find thye experience and entry that is needed.

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  26. Is there anyone willing to train a CCA in the Chicago area?

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  27. I am a recent HIM graduate with my RHIT. I have been looking for a job..ANY job in a HIM dept of several hospitals… I have applied to about 37 positions in 14 different hospitals. I am not even getting any phone calls due to my lack of experience in the medical field….this is very disheartening. I had my heart set on coding, but after reading the above statements from even 4 years ago, I see nothing has changed.

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  28. Wow. I was going to go into the local community college program for HIM here (it’s very competetive – always full over a year before term begins; also, very expensive) but now I shan’t. Thanks for the advice! I really, REALLY appreciate it.

    You’d have thought with the demand for coders trained in ICD-10 for a rollout in 2014 (as of now – I don’t know how it can possibly be achieved at this rate) that the coders that have graduated already would have no trouble finding work. That is what I thought, at least, before I saw this thread – and many more just like it. Many programs are still teaching ICD-9 (for what purpose, I don’t know, with as little as they have in common) and ICD-11 isn’t far off from becoming the new international standard now, so what gives?

    Here’s what gives: greedy corporate America refusing to spend money on training, that is what. Color me not surprised; this is how capitalism works. Pfah.

    Back to the career-change drawing board for me, I guess …

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  29. I also have had a tough time finding work as an RHIT. I have spend a lot of money for my education and no work to be found for a beginner. I have applied to hundreds of jobs and ended up taking a job in another field because I must pay back my student loans. This has been a stressful degree with all my working experience and degree. Hope that this will turn around for all of those in the same situation. Good Luck!!

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  30. I just relocated from New York to Florida and was hoping to find a coding/billing job. But, just like all above, I have no experience in that field. How do you get started. I would be willing to do just about any position to get my foot in the door.
    Any suggestions?

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  31. Wow, I am writing a report for one of my classes as to why I want to enter the Coding field. I am in the first semester and am seriously thinking of changing my career path. So far the research that I have done and reading the above post makes my choice as a coder very depressing.

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  32. Kathy, you would save yourself a lot if sorrow by opting out of the HIM field before you get neck deep. The books and training are very expensive. Yiu get your certification, yet nobody wanrs to give you the benefit of the doubt….theee years experience? But they will tell you to go and network.is this a syndicated field?

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  33. Simply amazing that it is over 5 years since publishing this article and NOTHING has changed. Pathetic.

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