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.
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.
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!!!
— Beth
August 3rd, 2009 at 10:36 pm
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.
— Pati Cohon
August 4th, 2009 at 2:59 am
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.
— JOYCE GIBSON CCS, CCS-P
August 4th, 2009 at 6:23 am
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.
— Milton Matos
August 4th, 2009 at 7:44 am
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.
— Patricia Mickelson
August 4th, 2009 at 10:30 am
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.
— June
August 4th, 2009 at 12:39 pm
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.
— Noelle
August 4th, 2009 at 1:55 pm
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…
— Rebecca H
August 4th, 2009 at 3:50 pm
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
— Diann White
August 4th, 2009 at 4:01 pm
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.
— Kay A.
August 5th, 2009 at 3:50 pm
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.
— BC
August 7th, 2009 at 12:35 am
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.
— Stace
August 7th, 2009 at 2:25 pm
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
— Janis Hunter, CCS
August 8th, 2009 at 1:05 pm
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
— Matt
August 19th, 2009 at 11:54 am