As part of our series of question-and-answer chats with healthcare leaders, Raemarie Jimenez, CPC, CPMA, CPPM, director of exam content for the AAPC, discusses how healthcare reform will impact the profession and how medical coders can best advance their careers. AAPC is known as the organization for “Advancing the Business of Healthcare.”
What’s the biggest change you either already see or foresee with healthcare reform specifically for medical coders?
We anticipate there will be an increase in claims submitted with the upsurge of the insured population as a result of healthcare reform. With larger volumes will come more job opportunities in the business side of healthcare (eg, coders, billers, claims follow-up, denials management). Healthcare reform also includes quality initiatives. Claims data will be needed and quality measures will need to be accurately reported. This goes hand-in-hand with accurate coding. There will be a bigger emphasis on thorough diagnosis coding to support the quality measures reported.
What are the biggest changes in the workplace for members of your association?
Coders will need to stay educated with the regulatory requirements for new payment methodologies such as ACOs and HCC coding. ICD-10 is another big change in the industry. Coders that do not have a strong understanding of medical terminology, anatomy and pathophysiology will need additional education. Coders must be educated on the ICD-10 code set and have adequate time to practice using the ICD-10 codes prior to implementation Oct. 1, 2014.
There will be a loss in productivity as the industry adapts to ICD-10. This may bring a need for additional coders and could result in longer work hours to make up for the loss of productivity. We also expect there to be an increase in claim denials and claim delays as a result of the shift to ICD-10. Dedicated staff must be available to quickly work the denials so that the reimbursement does not suffer.
What specialties or certifications do you see growing in the next five years?
It is really difficult to pick only a few. Any certification dealing with the business side of medicine will grow. There will be an increase in the need for clinical documentation improvement with the emphasis on quality care and reporting instead of fee for service. With all the governmental incentives and programs, there will be a larger need for auditors.
For newcomers in coding, what’s your best advice?
It can be difficult to land your first coding job. Be willing to take any job to get your foot in the door. Any job that you take in healthcare will help you have a better understanding of the industry. Once you prove yourself to be a valuable team player, opportunities will come. Strive to be the best in whatever position you take on. A good work ethic is hard to find. If you are not dedicated and committed to doing your absolute best with every opportunity, you will have a hard time making it in this industry. Keep in mind that physicians are counting on you for healthy revenue streams.
And for mid-career professionals?
You need to be willing to evolve with the industry. Enhance your skills. The days of the heads-down coder are changing. There is a need for coders to be multiskilled. We must learn to embrace technology that will help us be better at our jobs. Stay up-to-date on all the changes in the industry. As payment models shift, we need to determine how our workflow will change and adapt to it so that provider reimbursement does not suffer. Continuing education and flexibility will help set you apart from peers.
Our series of question-and-answer chats features leaders in various healthcare organizations and associations. Want your association leader to share their vision for the future of healthcare? Email your contact information to the firstname.lastname@example.org.
© Health Callings, Dice Holdings Inc., 2013