Reinventing the Role of Medical Coders in the Artificial Intelligence Era

Editor’s Note: This is an opinion piece submitted to the Journal of AHIMA. The opinions here reflect those of the author and not AHIMA. 

The goal of artificial intelligence (AI) is to replicate human cognitive processes. Thanks to the expanding availability of healthcare data and the quick advancement of analytics tools, it is bringing about a paradigm shift in healthcare. 

As technology develops, the nature of labor changes, as do the skills required for upcoming occupations. For the past 15 to 20 years, there has been a decline in the demand for manual and physical skills. The advancement of automation and AI will keep this continuous drop going. Improving working conditions and employees' employability depends on developing skills to increase productivity and sustain projects. There are numerous competencies regarded as essential for medical coders' upskilling to maintain work and succeed in the era of AI.  

Due to the exponential growth of technology and its ability to enable previously unheard-of innovation, experts believe that the upcoming decade will see significant changes like employment brought on by AI. Artificially intelligent machines are gradually replacing laborious, mechanical, and routine human operations like scheduling, documenting, inspecting equipment, gathering data, and performing initial assessments. Medical records and health information professionals' overall employment is anticipated to increase by 8 percent between 2022 and 2032, or as quickly as the average for all occupations, according to the US Bureau of Labor Statistics. Medical coders' skills are still in great demand due to the predicted continued exponential rise of healthcare data and its complexity. 

Medical coding, like many other professions, has adopted AI to assist with data extraction from medical records and application of proper codes. Medical coders need to start thinking about new skills that won’t be mechanized easily, things robots and AI won't be good at. This includes advancing “soft skills,” such as communication and interpersonal skills, leadership, and embracing change.  

Medical coders must possess several abilities, including the ability to adapt to change, pay attention to detail, and apply critical thinking to keep up with technological improvements. Anyone who wants a lengthy and fulfilling career in the sector will see the work role change and the importance of soft skills increase.  

Adapting to Change 

"The ability to adjust is the measure of intelligence," said Albert Einstein. You cannot advance if you do not change. You cannot be intelligent if you are not growing. 

Employee skillset requirements are shifting along with the changing competitive landscape that organizations must navigate. The modern world is one in which technology is continually evolving and changing how work is done. 

Adaptability is the top critical and most difficult-to-discover skill that cannot be fulfilled by machines, according to a PWC Global Workforce Hopes & Fears Survey 2023. Additionally, the study showed that 52 percent of respondents have a more favorable attitude toward AI. 

Medical coders must practice being flexible and acquire the capacity to accept, and even relish, change. We must be adaptable to changing workplaces, expectations, and skill requirements. And, most importantly, we must view change not as a burden but rather as a chance to advance.  

To reap the benefits of all that AI has made possible while still valuing human intelligence and emotions, we need to approach it with excitement and an open mind. We must recognize our collective abilities and realize that the choice is not between people and AI, but rather how to create a future in which human intelligence and AI coexist and work together. 

Attention to Detail 

A web-based system that analyzes provider documentation for treatment and recognizes the pertinent medical codes from its pre-defined medical coding list is automated by AI. Medical coders' workload is also lessened by AI software, allowing them to concentrate on more important tasks or those that AI has not yet been able to help with such as upgrading soft skills.  

AI only completes the tasks for which it was created or built; anything outside that usually results in a crash or ineffective outputs could have a significant impact. The technology bases all of its choices exclusively on the data it is given as input, and this data must accurately reflect the demographics of patients. 

AI gives immediate feedback and focuses on the smallest things that need the coder's attention. Although workflow automation reduces errors, strong attention to detail is still necessary. To efficiently record and code all patient information, all coders must be extremely detail-oriented. Careful management of patient health records is necessary, which necessitates accuracy. 

Accuracy is required to manage patient health records carefully. The basis of coding is meticulous attention to detail. As Apple's co-founder, Steve Jobs, said, "Details matter; it’s worth waiting to get it right.” 

Critical Thinking 

AI speeds up the learning process for humans facing difficult problems. Although there are still some restrictions, it can find previously undiscovered algorithms and even spot patterns in data and images that are invisible to the human eye. 

AI’s code prevents it from coming up with original solutions to a variety of new issues. The technology is unable to analyze the context, think critically through complex events, or devise sophisticated strategies because it is conditioned to operate inside its frame of reference. Human teams and their organizations connect with the outside world regularly, whereas AI is limited to processing information that has been input into its system.  

In healthcare work environments, it's important to have the flexibility to distill a vision and plan while coping with abrupt changes and skewed information sharing. Human intuition, which is a crucial component of daily labor, fuels this skill. AI is limited by its coding and its inability to think. It has little capacity for complicated, divergent thought on its own. By giving healthcare staff the correct information at the right time, AI improves our ability to analyze and make decisions; it also fosters creativity. Asking "what,” “why,” and “how” questions help medical coders develop their ability to think critically, predict what will happen next, and explore appropriate solutions. 

This ability is essential for examining provider documentation to decide how to classify it appropriately. An individual with the soft skill of critical thinking may use objectives, knowledge, facts, and data to solve problems successfully. Even if AI continues to improve workplace efficiency, it still lacks the human touch. The employee can use AI to make informed judgments by using critical thinking. Thus, critical thinking skills work in tandem with AI to enable the seamless operation of the intelligent system. 

As coding and real-time feedback are augmented by AI, medical coders can contribute value to the industry by honing and concentrating on these competencies. Consequently, it is possible to avoid a post-billing audit that leads to claim denials. Natural language processing analyzes electronic patient record material for important ideas, identifying the various ways those concepts are expressed and assigning diagnosis and procedure codes. AI then uses this information to extract medical diagnoses and treatments. The allocated codes are then examined by AI to detect any problems. When a code is accepted or rejected, the coder verifies the accuracy of the codes, and the software gets smarter as a result. Hence, there is a shift in the empowerment from the role of a medical coder to a medical auditor. 

Humans Provide Value That Machines Cannot 

Medical coders benefit greatly from AI in this aspect. With the aid of clever AI solutions, medical coders can now do their tasks quickly while concentrating on their quality. Medical coders can acquire new skills and stay current with the industry's shifting trends by adapting to this technology. 

Worldwide, the use of AI has accelerated industrial progress and had a beneficial effect on the healthcare sector. To better grasp how smart machines function, medical coders might think about picking up some new skills. 

While the usage of AI appears to be growing unabatedly, it's simple to forget our importance in a workplace where this technology is poised to be king. However, these technological advancements serve to highlight the traits that set human capabilities apart from those of computers. Human imagination, wisdom, and contextual awareness are essential to the success of AI.  

Humans will still be able to provide value that machines cannot. People will have to decide which problems to solve and how to solve them when machines take over lower-level activities. By maximizing their effort to maximize achievement, AI will assist medical coders in optimizing the quality of medical coding. Medical coders will have the opportunity to work to raise the standard. The paradigm changes toward understanding and utilizing cognitive intelligence will soon be required of medical coders. 

Even with technological advancements, an increase in healthcare claims may result in a rise in the demand for a coder's skillset. We need to be more deliberate about how, when, and why we use this technology, as well as its restrictions.  

Vatsala Muthukumaraswamy, CCS, COC, AHIMA-approved ICD-10-CM/PCS trainer, is senior manager of coding with AGS Health, a provider of revenue cycle management technologies, services, and support.