Will Coders Ever Return to the Office?

Will Coders Ever Return to the Office?

Tune in to this monthly online coding column, facilitated by AHIMA’s coding experts, to learn about challenging areas and documentation opportunities for ICD-10-CM/PCS.

I remember reading an article in 2001 that described how a health information management department had successfully implemented a remote coding program that resulted in boosted retention, increased morale, and improved overall performance of the department. Even though 2001 wasn’t that long ago, it feels like it has been much longer since the days when many coding professionals were working in the basement of a hospital, still coding from paper charts, the idea of being able to work from home much more dream than reality.

Fast forward to today, and it is an expectation that coders to be allowed to work from home, whether it be from day one or after a brief period of training. Coders want the guarantee that they will be allowed to telecommute at some point. Many people enter the industry with the main objective of someday being able to work from home. There is no denying that remote work has been a major factor in job satisfaction. However, initially, it wasn’t all about the coders. There was a lot of benefit in it for the employers. Employers believed that coders would be more productive if they could work from home. In addition, it opened the candidate pool for those employers with the ability to hire in different states. Coders could live in Ohio and work for an employer in California without having to relocate. Employers would no longer have to pay for contract coders to come work onsite. It was ideal for both parties.

There were other industries in the telecommuter game long before healthcare. In recent years, some of these industries have begun to call their employees back into the office. In March 2017, IBM announced that thousands of employees would return to the office; this came after employees had been allowed to work from home for over 30 years. Yahoo, Aetna, Bank of America, and Best Buy are some other employers that have cancelled or revised telecommuter work policies. There have been many reasons and opinions given on why these companies chose to bring their employees back into the office. To generalize, it simply did not work for the business needs of the employer.

Will this be the case in healthcare?

Are coders still more productive when they work from home? That’s debatable. For one, there are so many more distractions than there once were (e.g. social media and Netflix). Sure, many coders are dedicated and fully meeting the productivity requirements. However, there are some that are not. Some appear to be but when you really look at the data there are large gaps of unaccounted-for time.

Are employees still engaged? One could argue that a tradeoff of working remote was employee engagement. Do you remember the days when you could just lean your chair back and ask your coworker a question? Sure, we have Skype and email no, but many coworkers don’t know each other. Many have never met. Remember when you and a group of your coworkers used to go to lunch together? When you celebrated baby showers, weddings, and birthdays in the office? When you were genuinely connected and knew your coworkers? Times, it seems, have changed.

Are coders still climbing the coding ladder? Career advancement may be impacted for telecommuters. If a promotion requires a coder to come back to the office, they may not be interested. And for those that would be willing to return to the office for a promotion, they may not be on the boss’s radar. A study cited by the New York Times found that employees who worked from home are half as likely to be promoted. The workers in the study were considered to be happier overall, but 50 percent eventually asked to return to the office, citing loneliness (lack of engagement) and lack of career advancement.

Again, remote work has been a major source of job satisfaction for many coders and has been beneficial for employers as well. But it hasn’t been all peaches and cream, and I find myself wondering whether or not it will be the norm forever. What do you think?


Elena Miller is the director of coding audit and education at a healthcare system.

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  1. I have been working from home for 10 years. I will admit that it is NOT for everyone. The level of motivation required is nothing to compare to the level of motivation required to work at an office. There are no limits to the distractions when you are working from home. Another challenge is planning. Once I overcame the distractions and mastered the art of planning, I decided I am never gonig to commute to work again. The benefits of working from home far outweighted the satisfaction of a promotion; that, as long as the money continues to come in and at the right level.

  2. I, too am graduating in May from a HIT program at a community college. I find the Catch 22 problem frustrating. Where I live, medical coding jobs won’t offer training. 3-5 years experience. How can I get a job when employers don’t offer training?! I would gladly work remotely. I just need OTJ training!

    1. I was retrained by my state as a coder. I applied at several offices and clinic in my community. I cannot tell you how many time I was looked over for some one who has 20 years of experience. However I landed a job as a Risk Adjustment Coder at a medical clinic. The clinic’s policy was to have me work in house. That was okay with me as I did my schooling online at home. I soon learned that school work was always there staring me in the face. From that standpoint I knew that I wanted to work in house. My home is my sanctuary where I rest, relax and entertain not work.

  3. Great article! I’m a new graduate from a HIT program and will soon be taking my RHIT exam. I like coding the best, but most hospitals in my area seem to have subcontracted the work out to other companies that have work from home employees. While I don’t mind doing that in the future, I would like to go to a building when I’m first starting out. Also, these companies seem to not hire new grads as much as those with experience. I find this frustrating as I need to get the experience and I feel the hospital setting can give me the most diversity in coding.

  4. Interesting topic and comments. I was surprised at how much remote coding there is and that the article discusses a return to office coding. In our part of Western Canada, we are still and always have been coding in basements of hospitals with paper charts, although the electronic record is only a few years away. Many of us are badly wanting to code from home, myself included, so I hope we can catch up soon and have this option. Strange that we are so behind in this.

  5. Remote coding should be available for medical coders who have a few years under their belt and can be organized while productive in the home atmosphere. Experience does count I believe before becoming remote medical coder. However being a medical coder in the physician or hospital office in which available to talk to another coder or get immediate assistance from manager or query a physician if required is vital in this specialty work too. The coding manager can break or make a department by being fair, knowledgeable, properly communicate with all and not showing favoritism. No one likes to deal with drama in the workplace and some may want remote coding jobs as an option.

    Medical coding is a skill which can be learned but depends on factors of proper abstracting. Medical coders should naturally reading the documentation for details while not relaying completely on the Encoder, understand bundling impact from the NCCI edits, and the nuances of the medical specialty coders must abstract…makes a good medical coder. Knowing all this plus understanding how to lessen insurance denials related to the assigned medical coding. Are remote and in office stationary medical coders familiar with the kind of insurance denials they can create? Medical coding errors of the wrong diagnosis and CPT coding sequencing can lessen reimbursements, assigning only one diagnosis code when the physician gives six diagnosis codes for the patient or understanding dopplegangers related to medical abbreviations in the notations. This involves improving and maintaining the critical thinking skills of professional medical coders in the remote or office locations.

  6. I worked remotely for three years as a manager. Personally my opinion is MUCH is lost with remote supervision, management and coding. There are definitely pros but certainly cons. I chose to come back on site due to the challenges of managing a remote team and lack of face to face collaboration with other departments which has become more necessary. Not only does production, but also quality suffers unless managed appropriately with a model that works and clear expectations. With significant IT challenges for remote workforce and inability to adequately onboard new employees I believe the cons outweigh the pros in my observations.

  7. We are each informed by our own experiences. I believe the way an employer has set up remote coding will greatly affect how the coders perceive its worth. A lot of the problems and benefits previously mentioned can be traced back to the model the organization has invested in. Productivity tools? Mine is using them, almost to a fault. Flexible scheduling? Check, with some conditions. Professional rapport? 1 year minimum onsite with other coders. We are already isolated from the actual clinics/hospitals, so we almost never get the benefit of talking directly with the providers in our huge health system. But there is still plenty of time to figure out who you can ask for help and who you shouldn’t ask for anything. I’m not saying my employer is perfect (FAR FROM IT), but right now their version of remote coding is working for me in this stage of my life and career. I think remote coding is here to stay, as long as the employer does it right and makes the correct adjustments to their models as they go. The key for us, coders, is to recognize when we are working for the wrong place with the wrong model, then move right along to greener pastures.

  8. I appreciate the opportunity to work from home in cases of inclement weather or family obligations interrupting the work day, but I personally prefer working in-house. It’s a much quieter atmosphere and easier to concentrate.

  9. I quit my remote coding job and left my career 4 years ago mainly because of frustration with lack of appropriate supervision of work productivity. Many of my colleagues were hardly producing at all. I never concluded how they got away with it. I know there are several factors that could have been involved, e.g., deception, favoritism, supervisors also not doing their job, lack of good IT products for monitoring employee productivity. I have a very strong work ethic, and I met or exceeded my productivity standards and the only way I could do that was by sitting in my chair and doing my work for the totality of the hours that I turned in and sometimes for longer. I didn’t do this by grabbing the easier charts either, as has always been a common bad practice by some in the coding workplace and is somehow still allowed by computerized workflow systems. And flexing my hours around things that were happening in my home always benefitted my ability to get my hours of work fulfilled each week. Lack of ethics in the work place is very startling and I firmly believe that it is proliferated in remote coding. The fact is, some coders are turning in hours that they didn’t work. I don’t think remote coding has to end (and you know this happens on site also) but supervision of it has to begin. Supervision includes staying in touch with those remote coders and listening to their concerns and recommendations. I realize I have been away from this work 4 years but guess what, I happen to know personally employees that are still with the same company and still not working the hours they turn in. And I have only spoken here of quantity while quality of the work is also widely mismanaged, (there is more to quality than the correct DRG).

    1. Conversely, I sit in an office and listen to some (not all) of the employees in the cubicles around me waste just as much time as any work-from-home employee ever has.
      Remote coders do not have the market cornered on dishonesty and laziness. It drives me to distraction.

  10. 50% are more productive at work if given an appropriate and quiet workspace. It is critical to monitor productivity because it just doesn’t work for some.

    They tend to become disconnected from one another, their supervisor, the doctors and changes that impact their job. Coders are important members of the healthcare team and it is best to have them onsite when possible and involved with physicians and peers face to face. They have a lot to offer but unfortunately when working remotely, their impact is diminished.

  11. Health care should get on the bandwagon of having voluntary remote coders. I did it for 9 years. I have been back in the office environment for 2 years, and not happy. too much gibber gabber and the office environment can be a deterrent to work performance.
    Management needs to stop “power trip” and allow for more flexibility.

  12. Bringing up job advancement is an interesting point I have not thought of before.Many coders are satisfied with being coders and don’t strive for supervisorial jobs(but coding supervisor jobs, especially for remote workforces are abundant,and the effective supervision of a remote workforce is a big challenge). I work for a company that has contracts with hospitals throughout the country and I am an inpatient coder. As a remote coder I do overall enjoy it but do miss having fellow coders to ask questions of. I wonder about future coders, how they will get adequate mentoring if senior coders are not in the department?

  13. Yes I believe remote coding will continue; you cannot always find coders in your area…..I love working from home much more than the office. The office held more distractions than my quiet office at home!

    I can easily email or phone fellow coders for a conference on a chart ……

  14. Remote coding is ideal for all concerned. There are coders who prefer socializing, but for the ones that are dedicated to their jobs and the organization they work for it’s a wonderful opportunity. Some of us are dedicated, especially if there are no children or they’re grown and gone from home.

  15. I hear what you’re saying about the trade offs of working remotely. When I was interviewed for my current position they offered work from home capability, I shot it down on the spot. For a new coder in particular it was a bad match. My coding certificate class at the community college was all online, no interaction hardly at all and it made it harder since if you had questions it was harder to get answers. It was so isolating. I ended up negotiating work from home only during times of unexpected building closure and guarantee that I would always have office space within clinic as long as I wanted. My office isn’t glamorous, it’s a converted storage room, but it’s quiet and I feel like I can do my job better since what can take 4 days to solve over email I can take a quick stroll and solve with a 5 minute conversation.

    1. I love working from home. I have been coding for over 30 years and home for 10. If i have questions I text or email. I have no desire to put up with office nonsense and personalities. If I wanted to climb the coding ladder, that would be an easy accomplishment – in office or remote. And I am more productive from home. Too many distractions in the office.

  16. Remote coding is definitely the norm. I am a coder and although I have the option to work from home, I choose to remain on site because I like interacting with other people. The vast majority of my coder colleagues and friends are working remote and love doing so. For some, having the option to code remotely is a deal breaker on whether those individuals will accept coding positions at certain establishments.

  17. I prefer to work in the office among my peers. It is difficult to discuss coding via the e mail , instant message. Working at home is lonely and distracting

  18. I totally agree. All our coders are in-house and have been. We interact bouncing coding questions off each other and help each other when it comes to coding some of those diagnoses that are difficult. Our doctor’s lounge is located in medical records which is the first office inside the door so we are able to also ask the physician for clarification. I can’t imagine not knowing and interacting with my co-workers. I’ve been to weddings and other important events in their lives. A lot of my friends are my co-workers in the facility. To me it’s definitely a positive.

  19. I agree it has it’s perks working from home, but I do miss the one on one contact with someone when you have a question. Sometimes it is much easier to explain the response face-to-face than in an email. Or just being able to see your co-workers and saying “Hello” in person.
    I do have the luxury of going into the office whenever I want or need to depending on what I am working on but others do not unless their PC or internet has an issue at home. I know that going in even one day a week has helped my mood and outlook on my job. But, when the weather isn’t so great I do like the fact I can stay home and not have to get out in it.

    All in all it is nice to work remotely, but being in the business for over 20 years and comparing working in the office to working from home I am still on the fence as to which one I truly prefer.

  20. This article is a good example of the trend. The author identifies her employer as “a healthcare system”. There was a time when we came to know the leaders in this field by their presentations, their publications.
    I personally know fewer and fewer of the HIM ‘persons of influence’. I must wonder if that might be because the actual target audience is on other ‘persons of more influence’ and there is really less interest in coming to know the newer and less outgoing/visible members of our professional community.

    Of course, this is my own experience and observation but the proof is in the pudding.

    1. I worked from home in other positions and other types of jobs for gosh, over 20 years. Unfortunately now, I am physically more in need of working from home then I was back then. Physically, now I have challenges that didn’t exist back then so for me that’s the biggest benefit for working out of my home office.

      At the time that I was doing it I was a stay-at-home single mom so it was beneficial to me for that factor of being able to be there for my children especially while going through a divorce. Now, I would actually prefer to work on an office, at least until I’m more comfortable with coding. That’s opportunity to have others mentor you which is invaluable.

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