by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA

With mandatory vaccine requirements in some hospitals affecting even remote workers and exacerbating already acute coder shortages due to the disruption of COVID-19, many coding departments are facing a serious shortage of skilled coding staff. Cross-training, up-skilling, or “grow your own coders” have been and will continue to be useful strategies to ensure adequate staff for the work that needs to be done.

Cross-training and upskilling, whether from outpatient to inpatient or professional fee to outpatient, works because it takes advantage of your existing coding staff as known resources. You know who is skilled, who is always the first to dive in and make sense of a coding problem, and those who will embrace the training necessary to prepare them for a new challenge.

“Grow Your Own Coder” is how most coders in the past learned their craft. The ‘old-hands’ would take responsibility for ensuring the new coding staff understood their job and were performing to exacting standards. Grow your Own is finding new fans in this coder-shortage environment with or without internal mentors to ensure progress. It requires an enthusiastic ‘newbie’ who is willing to embrace the structured training necessary, in combination with hands-on experience in coding of thoughtfully selected and progressively more challenging cases.

Whether repurposing existing staff or adding to your team from outside, what is the best way to ensure adequate coding staff? Here are 4 steps to get you started:

1. Identify those individuals who you believe have the best chance of success, whether they are internal staff or external candidates. Look for the ones who like a challenge, who work a coding problem until they know the answer, and who embrace change and rise to the occasion. Now is not the time for those who resist what their job demands of them.

2. Use a pre-employment coding test to ensure your newest coders exhibit at least some proficiency in coding. Use the same test to identify your candidates for cross-training and upskilling. A ‘failed’ coding test is not necessarily the final answer. The test results can be used to identify where training would be most beneficial. (If you don’t have an up-to-date coding test that can be delivered remotely, Libman Education has assessments you can purchase to help with this.)

3. Use your existing coders to orient their new colleagues and communicate the specific coding challenges your organization faces. Use your own records to familiarize the new staff with the providers and their habits of documentation. There is no substitute for real-world hands-on experience and a positive environment of esprit de corps will pay benefits for years to come.

4. Provide structured coder training that refreshes on basic principles, advances the coder’s knowledge through challenging coursework, and presents complex concepts tailored to the specifics of the new job. (Libman Education’s Accelerated Inpatient or Accelerated Outpatient Coder Training provides the essential training needed to help your best candidates progress.)

A better trained coding staff provides greater flexibility for your organization to deal with potential staff shortages and other unforeseen changes. For your coders, those who work to maintain and advance their knowledge, up-to-date and enhanced coding skills mean more job security, now and in the future.

Be ready for whatever change may come with a well-trained staff, ready to meet your organizational needs.


Cross-training, Up-skilling, or “Grow Your Own Coders”

How can you ensure adequate coverage for the ebbs and flows of the coding process? By building on valuable on-the-job experience and knowledge and supplementing these skills with the essential training necessary, coders are able to assume new responsibilities. Learn more here.