Questions and Concerns for Coding Professionals in 2020

Questions and Concerns for Coding Professionals in 2020

By Catrena L. Smith, CCS, CCS-P, CPCO, CPC, CIC, CPC-I, CRC, CHTS-PW


As the role of health information management (HIM) professionals continues to evolve, we must prepare for significant changes and trends in medical record coding in 2020 and beyond, including the move to value-based reimbursement, single-path coding, coding social determinants of health (SDOH), and reporting directly to revenue cycle. As HIM and coding professionals prepare for the year ahead, it’s important to recognize the pressing questions, concerns, and challenges facing coders just entering the field, coders pursuing a new position, and coding managers.

Advice for New Coding Professionals

Coding professionals who are entering the field should prioritize education and advancement and ask themselves the following questions when considering a new opportunity:

  • Is this an organization that offers experiential learning and support?
  • Will I have reasonable time to grow without being expected to know everything at once, or will I have to hit the ground running?

To ensure success, new coding professionals should work as hard as they can to find out more about an organization’s culture and reputation, which can be learned through talking to current and former employees and reading reviews on websites such as LinkedIn, Great Place to Work, Comparably, and Glassdoor.

Breaking through without experience in any sector of the healthcare field can be difficult and at times discouraging. It’s not at all uncommon for people in the coding field to search for up to a year before finding a job.

Coding professionals new to the field should consider these for suggestions as they look for a job and begin their careers:

  • Make finding a job your job. Market yourself consistently across various social media outlets such as Facebook, Twitter, and LinkedIn.
  • Participate in local chapters of the American Academy of Professional Coders (AAPC), AHIMA, and the Medical Group Management Association (MGMA). Look beyond attending meetings by connecting and communicating with others. Pursue educational opportunities that these organizations offer.
  • Ask members of your family as well as your friends if they have connections to people who work in healthcare facilities. For example, you might have a cousin who has a friend who works at a hospital—that is a networking opportunity.
  • Pound the pavement and apply to open positions in person. This approach may sound archaic in a high-tech world, but it can still work. Some small medical practices are open to this approach. Sometimes, coders fill out many applications online, but eventually received a job offer simply by walking into a small practice that had an opening that had not been posted online.
Experienced Coders Pursuing New Jobs

Experienced coders share some of the same concerns as new coders when it comes to pursuing a new position—ongoing education options, opportunities for advancement, a positive work environment, and supportive management. Assurance of a coding career path with specific goals that promote job security is a top priority. Seasoned coders with five or more years of experience typically want to broaden their knowledge and expertise to meet the demands created by evolving trends. They must be ready for the challenges related to value-based reimbursement requirements for documentation and coding that meet payer demands.

Single-path coding, which is a consolidation of facility and professional fee (pro-fee) coding, requires additional training to become proficient in both outpatient facility and pro-fee coding. Cross training on both sides is essential. Coders reporting to revenue cycle have opportunities to gain experience on the billing side, which expands their knowledge base and makes them more marketable. Coding for SDOH has productivity concerns as coders must have knowledge of specific factors such as transportation, living conditions, employment, and more. Use of SDOH codes can provide a more comprehensive account of the patient’s circumstances and guide referrals to proper resources. Even experienced coders need training to ensure understanding of these determinants.

Priorities for Coding Managers

New coders seeking their first jobs and experienced coders pursuing better opportunities should both focus on the necessary education and training to strengthen the following six traits most valued by coding managers:

  1. Variety of experience and expertise: Though specialized training is needed for areas such as anesthesia, cardiology, and orthopedics, a variety of experience and expertise can be a valuable asset. For example, two candidates may have the same certifications but entirely different backgrounds. The candidate who has multifaceted experience in billing, coding, denials, and compliance may have an advantage over the candidate whose experience is limited to inpatient coding. Given the shift to single-path coding, more managers are looking for coders who are cross trained on facility and pro-fee coding.
  2. Independent and resourceful: In today’s fast-paced environment, managers need coders who can independently conduct research in response to questions and difficult coding challenges. If a hospital is performing a new procedure, the coder should research the procedure to gain a clear understanding of how it is performed and coded.
  3. Reliable: Value-based reimbursement demands dependable coders who consistently meet and maintain quality and productivity standards. However, if a coder is struggling, I encourage them to ask for help when needed. Coders need to know they can rely on their managers for support. It’s a collaborative team effort.
  4. Proactive: Attention to detail enables coders to identify changes that might impact coding before it becomes a large problem. In one case, a facility restructured its surgery form, placing “HIV positive” at the top right corner of the form where “hypertension” had been. As a result, some physicians erroneously categorized patients as HIV positive. Fortunately, a coder caught the error.
  5. Professional: Coders are expected to communicate and interact in a professional manner. In an era of posting immediate reactions on social media, attention to proper grammar, spelling, and punctuation is often lost. Professional verbal and writing skills are critical to clear communication that supports accurate coding and documentation.
  6. Certification: A coding certification is typically required for any coder seeking a new position or career change. It is recommended that coders research the job requirements and certification expectations prior to applying for a position. This step will help determine which certifications are most important to achieve and maintain for your area of interest. Many hospitals want facility coders to hold AHIMA’s certified coding specialist (CCS) certification, the gold standard credential that prepares coders for both inpatient and outpatient facility coding. On the physician practice side, a certification in professional fee coding is likely a job requirement. Also, with the move to single-path coding, certifications in both facility and pro-fee coding are strongly recommended.

Over the next year, one of the biggest challenges for coding and HIM managers will be finding coders with the right experience in various areas. The top priority for coders is to focus on their chosen career path and determine how to attain the right credentials and experience to fulfill their long-term plan.


Catrena L. Smith ( is the audit and education manager at KIWI-TEK. She is a frequent speaker and presenter of webinars on topics involving coding, billing, documentation improvement, and compliance.


  1. Experience Coder RHIT member AHIMA. Very interested in learning more about PROfee coding. Hot area for coders right now.
    please send me pertinent literature, interested in class.

    Thank you

    1. My reply to your comment is I know, it is all so very interesting an exciting. That’s how I felt about coding. It still kind of is. But I see all the problems
      with what’s going on with this profession. Now everything has gotten so specialized and more cut throat with obtaining employment
      with coding jobs. My question: Do you currently or have you had a coding job where you did pro fee coding, but you want to take a class while your doing that type of a job? Or do you want to take a class and use that on a resume to get a job where there is pro fee coding involved? Why I’m asking this is because there
      are too many employers of coding that want you to have real job experience doing that to get a job regardless if you took a class or got certified in it. Is that
      fair on the employers part to do that?? No, absolutely not. Why? because It would be unfair and really makes no sense for a person like yourself or myself to dedicate time and money to taking courses in certain areas, or getting a certification, then not be able to utilize it. But that’s where things need to change on the employers part. Furthermore, there really should be laws, which there is not, that mandates employers to do certain things when it comes to filling positions. Ex:
      the next time we hire for the same position, we now have to pick someone who has no experience or some knowledge, or not a lot of knowledge, but has the course work or certification. Any comments?

      1. I would like to add my comment on this subject. Our profession is interesting and exciting, but also frustrating some time. I am PROfee coder with years experience and like Kimberly stated want to learn something different in our profession – IP coding. Little more then year ago I took class, learn on my own and obtained CCS certification. After that I applied probably about 50-60 jobs with dedication to find hospital coding job without any luck. I have an experience of working with IP, OP and procedures for PROfee coding and still no one wants to give the job to not experienced coder, So, if anyone from employer point of view can advice how to expand our profession and stay positive, keep learning and still be excited.

      2. I agree with Reliable, under priorities for Coder manager should be knowledgable and available to the coder, this is missing in the Coding Department, I have worked under so many unqualified Coder managers, they are there in body only, because no one else wanted the Job. They expect Experience Coder to make all the decisions. when you asked question, the unqualified managers, tell the coder, you make the decision. I agree with Kimberly statement above. I have a suggestion experience Coder should pair up with new Coders, help with the experience of coding, making decision, communicate with auditor. Teams effort is so hard sometime for New coders. Experience and New Coders need support from the Manager.

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