Hiring crunch for coders leaves many providers unprepared as ICD-10 takes hold

After a number of delays, and much anticipation, the implementation of ICD-10 is finally underway as of Oct. 1. But with all the competition in the job market this year for skilled coding professionals, some hospitals and healthcare organizations may have yet to start the journey.

For them, the best hope at this point is to bring in an outside firm to handle the effort, experts said.

"The costs and complexities of catching up now as a result of not implementing effective ICD-10 changes will be significantly greater than if they had devised and executed a thoughtful plan in anticipation of the new system," said Steve Jacobs, an executive healthcare recruiter with Healthcare Recruiters International. "If a provider is currently in this situation, hiring an ICD-10 coder or two will likely be too little, too late. There is just more involved than hastily hiring coders at this stage. They would be well advised to call in an expert third party to help them manage their claims and billing systems."

[Also: ICD-10 arrives: Updates, reactions from the first day of the code change]

While certain technology jobs have gotten much of the glory this year – data analysts, security professionals and mobile application developers, to name a few – ICD-10 coders have also been in high demand and most have been scooped up.

"It has been estimated that unemployment figures for medical coders are well under 5 percent -- a number effectively representing full employment for this employment class," Jacobs said. "Salaries and benefits are increasing accordingly as demand, especially for certified ICD-10 coders and those in training and leadership roles, is outpacing supply."

Get to work

For the ones that have been hired, there are two primary functions that coders have had to play through the implementation phase of this new medical identification system, Jacobs said. First, there's training.

"To work with the clinical team to make sure the descriptors for each diagnosis is consistent with new billing codes. As the number of new codes has more than quadrupled from 14,000 to 70,000 this represents a significant risk to speed, efficiency and accuracy," he said.

Next comes the all-important integration with existing software and practices, especially billing/revenue cycle teams both internal and through third-party partners.

That's good news for skilled coding professionals, of course, who are benefitting from lots of both short- and long-term job opportunities.

"Hospitals and mid-to-large physician groups in particular are likely to maintain long-term positions," Jacobs said. "In addition, a wide variety of healthcare business consulting firms and third party/outsourced service providers serving these entities need expertise during this transitional period as well (think HR Block during tax season)."

As for hiring managers still on the prowl for these professionals – well, the news isn't good. If you don't have a full complement of coders already in place you will probably fall behind on billings and reimbursements.

A struggle to hire

David Lane, healthcare revenue cycle management consultant in Chattanooga, Tennessee, said that the transition to ICD-10 was the No. 1 challenge this year for many healthcare organizations, especially the struggle to find enough talent.

Bryan Chalmers, CFO at Ivinson Memorial Hospital in Wyoming, saw that struggle first hand.

[Also: 5 things we learned from the ICD-10 rollout in healthcare]

"The hospitals that were already set up to go live last year, they've got to retrain staff," Chalmers says. "Other hospitals that were maybe a little behind, they've still got to get the education out; they still have to be able to get the systems tested and in place, and that amount of workload on top of meaningful use – you're just going to have a human resource issue."

Jacobs was far more dramatic.

"The implications of this scenario would be financially devastating. Incorrectly coded claims will result in payment delays, rejections and very likely audits," he said.

Picking up the pieces

As for the coders themselves, it may be too early to tell how well they will benefit from ICD-10 and other developer projects in healthcare.

"It is difficult to say how their long-term career options will be affected, specifically by the introduction of the ICD-10 system," Jacobs said

"Certainly in the short term there will be significant upside for those coders who embrace change and see themselves as architects rather than maintaining the status quo of a well-vetted, familiar system," Jacobs said. "Keep in mind that this new coding system will replace the old, so the expectation for both the aspirational as well as the rank-and-file coder will be to make the transition, or risk becoming obsolete."

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Not to sound all doom-and-gloom, Jacobs said there are plenty of healthcare providers who will weather the changeover just fine, as long as they stay vigilant.

"Coders need to have a strong attention-to-detail disposition. Incomplete or improperly coded claims will result in processing and payment delays along with other secondary and associated costs. They also need to develop and maintain a broad knowledge of clinical terms and diagnoses to help identify potential coding inaccuracies. As with all careers those coders who have passion for what they accomplish and contribute each day will do just fine with this new system," Jacobs said.

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