It pays to know the medical code

DALLAS — Marcie Jump wanted to work in health care but without the usual patient contact. A job in medical records was — and still is — an ideal fit.

"It's like a puzzle," explained the 30-year veteran. "You assess the medical record, you pull up the diagnoses and procedures that occurred during the medical stay, and we convert those into codes for reimbursement purposes."

Tumor registries and mortality statistics rely on this data as well, said Jump, a registered health-information technician and certified coding specialist at Baylor University Medical Center in Dallas. Her employer is Kforce, based in Tampa, Fla.

"Each case is different, and there's not a day that goes by that I don't learn something," she said.

Although most of these technicians work in hospitals, others fill needs in physician practices, nursing facilities and home-health agencies. Job openings have doubled the past two years and remain on the rise, with salary growth reflecting the demand, according to the American Health Information Management Association (www.ahima.org).

With the shift toward electronic medical records, skilled coding specialists are finding their services increasingly in demand, said Dr. Claire Dixon-Lee, the Chicago-based association's vice president for education and accreditation.

The new technology has expanded opportunities for telecommuting and working from home. Meanwhile, the coders' image has undergone a transformation. Once viewed as librarians of data, today's professionals are perceived as valuable players in maintaining profitability, according to Kforce.

"Coders need to be highly trained in reimbursement requirements, biomedical sciences, pathophysiology and privacy practices to maintain compliance with government and insurance regulations — ever-vigilant to guard against fraudulent billing practices," Dixon-Lee said.

An upcoming overhaul of the International Classification of Diseases directory will require professionals to assimilate new technology and many more codes.

The updated diagnostic classification set includes about 120,000 codes — nearly 10 times the current number. Coders also will need to learn the procedure usage set, which has more than 200,000 codes — about 50 times as many as it has now.

The best opportunities go to coders with an associate degree in health-information management and the credential of registered health-information technician, which is obtained through the association.

Additional credentials, such as certified coding associate and certified coding specialist, boost the chances for employment.

Staffing agencies play a role in placing coders and tend to pay more than hospitals, experts say, but applicants also work directly for employers.

Kforce reports that 62 percent of coding professionals earn $30,000 to $50,000 per year. Nearly half of managers — 49 percent — bring in $40,000 to $60,000. For consultants contracted by staffing firms, salaries can be even higher.

"The trend is to hire credentialed or degreed coders," said Sally Nelson, co-owner of Impact Associates, a Dallas-based health-care consulting firm that provides coding services.

"The most challenging problem for newly credentialed or degreed coders is finding employment without experience."

In major cities, she added, the shortage of coders is no longer as critical as in rural areas.

Prospects appear rosy for seasoned coders.

"There is a huge job market if you're experienced in this area. You can pick and choose your job," said Sam Farrell, group president of Kforce's health-information-management division.