Case Summary

OCTOBER 2018 ∣ Urology Times ∣ 39

CODING / Business

KIMBERLY CLARK

Ms. Clark is associate editor for Urology Times sister brands

Medical Economics and Physicians Practice. This article was

originally published by Physicians Practice.

I naccurate coding remains a main cause of lost revenue for a medical practice, high- lighting the value of an on-staff profession- al coder.

Skilled coders are in high demand, so recruit- ing and retaining the right candidate presents a challenge. The unemployment rate for coders saw a slight decrease from 6.6% in 2016 to 5.9% in 2017, according to the 2017 Salary Survey of nearly 13,000 respondents conducted by AAPC (formerly known as the American Academy of Professional Coders). However, the average salary for all employed respondents grew 6% to $52,648, meaning employers will likely need to pay more to keep or attract coding talent.

“With the unemployment rate [for coders] so low, the job market for employers is more com- petitive,” said Raemarie Jimenez, CPC, vice pres- ident of membership and certification solutions at AAPC in Salt Lake City. “You are competing with other practices and other opportunities where [coders] have more options.”

Your current staff often can be the best source for new coding talent. “One thing you should look at is helping an internal person who you want to retain get those [coding] skills. Invest in [his or her] training,” said Laurie Morgan, MBA, part- ner and senior consultant at Capko & Morgan, a medical practice management consulting group based in California. “It’s not always that easy to find ways to give people career paths inside of a practice. This is one area where you really have an opportunity to do that.”

But if you lack that opportunity, you will need to look externally and not only attract the most qualified candidates but also provide a competi- tive employment offer. Here are some tips to help ensure that you choose the right coder for your practice, and that the coder chooses you back.

Determine your coding needs

Because a coder can contribute at multiple stages during the revenue cycle, defining the coder’s role and responsibilities is the first step of the hiring process, Morgan says.

Morgan recommends practice leaders—which can include the practice manager or administra- tor, the practice owners, and the manager of the billing team—meet to align on what the coding job will entail and develop a comprehensive job description.

“[They must decide] if this person is working only on coding or on billing as well,” she said.

A coder by trade, Astara Crews, CHC, CPC, director of regulatory affairs at ENT & Allergy Associates LLP, a group practice with offices in New Jersey and New York, says that the coder’s role often depends on a practice’s size and revenue because smaller practices tend to not have the business need and/or resources to support distinct coding and billing roles.

But having a joint biller and coder role can be valuable to a practice.

“Having [a biller] who is aware of the cod- ing rules adds that extra layer of assurance that [claims] are not going out fraudulently,” Crews said.

Describe your ideal candidate

In order to screen the best candidates, identify the qualifications and experience a coder must have to be successful in the coding position in addition to the soft skills needed to work effectively with other staff members.

Jimenez recommends limiting your scope to candidates with professional certification.

“[Practices] are not giving enough weight to

certifications. They will hire someone just to sit in that seat, thinking that [coding] is an easy job, and they don’t get well-trained individuals. If they’re certified, you know they’ve passed an exam showing competency.”

Keep in mind that individuals could have a compelling case for why they would excel in the position, even if their backgrounds do not exactly match the job requirements, Morgan says.

For example, do not discount candidates sim- ply because their certifications are not specific to your practice’s setting or specialty.

“If the candidate learned how to do coding suc- cessfully for several different specialties in the past, then that may be an indication that they will be very adept at learning a new specialty,” she said.

Furthermore, coders who are new to the indus- try can become valuable assets if training and supervision are available.

“I used to work with coding externs who were completing a course and getting certified,” Jimenez said. “For me, it was beneficial [to host them] because they came with no bad habits, so I was able to teach them the way I wanted it done in our particular circumstance.”

Create a compelling job ad

Pique applicants’ interest by posting a job ad that not only includes key information about the job but also demonstrates why applicants should want to work at your practice.

Posting the job description alone will not be alluring to applicants because it will be too bureaucratic, Morgan says.

“You need to convey your practice’s personali- ty, history, and mission. Why is your practice an exciting place to work? Is your practice a dynamic place to work? A compassionate place to work?”

Also consider how digestible your job ad will be for a reader, Morgan says. For example, avoid large blocks of text and the use of obscure or vague terms to describe the job duties. Use bul- let points, shorter phrases, and clear language.

Recruit from the right places

Engage in both active and passive recruitment to generate a strong candidate pool.

To reach candidates actively searching for a

Hiring a coder: How to recruit and retain the right candidate Follow these tips in order to land the ideal hire for your practice

“[Practices] are not giving enough weight to certifications… If they’re certified, you know they’ve passed an exam showing competency.”

RAEMARIE JIMENEZ, CPC

VICE PRESIDENT OF MEMBERSHIP AND CERTIFICATION

SOLUTIONS, AAPC

Please see CODER, page 40

40 ∣ Urology Times ∣ OCTOBER 2018

Business / MALPRACTICE

job, post your job ad on general job sites, your practice’s website, and social media accounts as well as job boards specific to coders, such as the AAPC health care job database, Morgan says. The American Health Information Manage- ment Association (AHIMA) also offers a service called AHIMA’s Career Assist that can connect employers with coders.

Social media provides an opportunity to con- nect with individuals who may not be looking for a job but have the skill set you need. On LinkedIn, individuals often list credentials after their name, so you can identify certified coders and reach out to them, Morgan says.

Your current employees are an additional source for new referrals. However, smaller practices may need to be more cautious. While you should let your staff members know the position is open and invite them to nominate candidates, “you want to have some boundaries,” said Morgan, who thinks paid referral programs are especially risky for small practices. “You don’t necessarily want relatives working with one another. If you have a very small team, having people who know each other too well from outside of work can introduce drama.”

Ask the right questions

Use interviews to ascertain if candidates possess the necessary coding acumen as well as the soft skills to be successful in the coding position.

Brief phone interviews may prove useful if

the size of the candidate pool is substantial. Conduct these calls with applicants to learn more about them, their background, and level of interest in the position, Morgan says, noting that open-ended questions that allow applicants to talk about their skills and interests are best (Why are you looking for a job? What attract- ed you to apply to this position? Why is this position a good fit for you?). If an applicant still seems like a good match after the phone inter- view, then bring him or her in to interview with the manager and other relevant staff members, she adds.

Jimenez suggests asking candidates about previ- ous coding jobs they’ve had and what roles they’ve performed, their productivity and accuracy rates when selecting codes, and the results of any audits. She also recommends requiring an initial assess- ment to test candidates’ ability to complete the type of coding expected by the position.

It’s also important to pose behavioral or situa- tional questions to determine how well a candidate is able to work with others. While some coders may spend the majority of their time poring over charts in the back office, a practice really should look for a coder who can communicate reasoning behind a code selection, navigate through dis- agreements with a physician or other staff mem- bers, or simply share new findings, Crews says.

“As a coder, the primary function is not only to code a service but also to interact with [the team] as part of education,” Crews said, noting that a coder needs have interpersonal skills and be adaptable to change.

As a competitive salary typically is the main

draw to an open position, consider setting the salary for your coding position in line with what other practices provide.

The AAPC salary survey calculator is a useful resource for practices that want to judge if their compensation offerings are competitive, Jimenez says (bit.ly/AAPCsalarycalculator). The calculator allows employers to search the average state salary by certification, education level, and health care work experience.

But if your practice cannot afford to match what other practices pay, additional benefits such as a 401(k), vacation days, and sick leave can make your position more attractive. Coding also lends itself to remote work, which Jimenez says “can be a significant financial saver for the individual and employer” as well as offer the individual more flexibility and work-life balance.

Crews suggests providing career growth opportunities and support to attract candidates. Think about covering the cost of the coder’s continuing education units that are required to maintain certifications, membership dues to professional organizations, or providing finan- cial support and time off to attend professional conferences, she says.

“To be competitive, I think a practice should look at the individual as not just a body to fill a seat or a body to fill a coding position… but look at the individual as a whole and try to recruit indi- viduals based on what they have to offer,” Crews said, stressing that “not-so-great salary” can be offset with opportunities for professional growth and development to successfully attract coding talent. UT

Malpractice insurance: Considerations when buying a policy Hiring a carrier based on price alone can have consequences, expert warns

JAMES F. SWEENEY

Mr. Sweeney is a contributor to Urology Times sister brand

Medical Economics, where this article was originally published.

M edical malpractice insurance is one of the greatest expenses phy- sicians face during their careers. But knowing what to look for in

a policy is a mystery for many physicians, as well as a time-consuming chore that rarely gets the attention it deserves. And buying the wrong type

or incorrect amount of insurance—or buying it from the wrong carrier—can be extremely costly.

Physicians who take the time to understand how to buy malpractice insurance will not only save money, but ensure that they’ve got the right type and amount of liability coverage.

Types of insurance

Policies typically cover expenses incurred while defending and settling malpractice suits. These can include attorney fees, medical damages, arbi-

tration and settlement costs, court costs, and punitive and compensatory damages. Liabilities incurred from criminal acts or sexual misconduct usually are not covered.

There are two basic types of malpractice insur- ance: claims-made and occurrence. A claims- made policy provides coverage only if the policy is in effect both when the incident took place and when a lawsuit is filed. Occurrence policies cover any claim for an event that took place during the

C O D E R continued from page 39

Please see INSURANCE, page 41

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