A certified medical coder plays a critical role in your organization for two reasons. First, coders translate the patient record details into codes used by insurance companies to determine how much they reimburse the physician practice or hospital. Second, because the codes adhere to the national standard (ICD-10), they can be analyzed to determine how well, or not well, a certain condition is being treated—by a single physician, by an entire hospital or physician group, or worldwide.

Sounds like a well-oiled machine, right? The truth is, great coders are hard to find—here are three reasons why you might be struggling to hire, train, and retain excellent coders. Incidentally, they are the same three reasons that outsourcing coding to a proven partner is often the best, most sustainable way to ensure coding drives your revenue cycle as it should.

1. Coder turnover is high.

Medical coding is a trade, albeit one requiring a highly specialized skillset and, more and more, certification by a nationally recognized credentialing organization (AAPC or AHIMA). Coders can take their skillset and certification practically anywhere and thrive. And they do. Because demand is high and supply is low, coders are quick to gravitate to the employment opportunities that suit them best. This means that the investment you make to hire, train and retain a certified medical coder can be lost in a heartbeat if a better opportunity arises. As an example, with the widespread adoption of EMRs, coders can code from anywhere, so working remotely is often an attractive perk that lures coders to new opportunities.

How outsourcing solves this problem:

When you choose a partner to help with or assume all medical coding operations, the costs mentioned above are no longer yours to bear. The outsourcing partner is responsible to build an environment in which the coders can flourish, and in which they want to remain, regardless of whether they work remotely or on-site.

2. Training and certifications are time-consuming and expensive. 

Coding is perpetually changing. Yearly updates to the code sets and changing payer regulations mean that to be on top of their game, coders must stay current not only with their certifications but also within their specialties. Continuing education for coders is expensive and is sometimes viewed as a time-suck, as it pulls coders away from doing what they do best — code. Like any other planned or unplanned coder absences and leaves, this can create backlogs and bottlenecks.

How outsourcing solves this problem:

Coding partners assume the responsibility for educating coders and keeping certifications up to date. Unlike hospitals and physician groups with limited coding staff, coding firms have the ability to shift staff from project to project as needs arise, filling in any gaps regardless of how or why they occurred.

3. Finding “any” coder is different than finding the “right” coder.

Some organizations know they need coders, and so they hire “any coder” — but that is rarely the answer to a shortage. Just because a coder has a certification doesn’t mean he or she can jump into a new environment and code with 100% productivity from the get-go. It’s imperative for new coders to understand the overall goals of the coding division within the organization, as well as its policies and procedures before they lay a hand on the first chart to code.

And, inevitably, there will be specialty training. For example, a coder with experience in a family practice group may jump in easily to code pediatric and immunization visits, but if he or she is hired into a neurosurgery clinic, there will be a steep learning curve.

How outsourcing solves this problem:

A partner who truly acts as an extension of your coding operations will take time to learn about your organization, staffing models, and policies. They will already be fluent in the specialties you need. Case in point, at Tegria, we’re constantly cross-training coders behind the scenes, so that we’re ready to step up to any need at the precise time a request is made. A great coding partner offers flexibility to meet any need, whether it’s front-end coding in a specific specialty, edits, working denials or beyond. And they will already have in place the checks and balances in the form of internal audits to ensure quality, accuracy, and productivity commitments are met.

The Bottom Line

Hiring the right coders to keep your revenue cycle turning efficiently has become a tall task fraught with more than one stumbling block: the certified medical coder market is tight, the cost to train and maintain is high, and your “investment” is never guaranteed. If you’re hiring, understanding why it’s hard is half the battle. Build an environment in which coders will thrive, take time to vet and evaluate coders for quality and productivity, and if you still don’t find what you’re looking for, consider outsourcing coding to a proven partner who will keep your revenue cycle moving forward.