Hint: Start at the foundation by focusing on the job description.
Organizations can cultivate the kind of coders they need through years of work and nurturing expertise and professional development. But when organizations need a top-notch coder right away, they need to bolster their hiring practices to make sure they attract the best candidates possible.
Pocket these tips that Jeannine Bumford shared during her AAPC’s RISKCON 2024 presentation “Strategies to Increase Coder Precision.”
Be Meticulous With First Impressions
The job description is first thing that most candidates will see when they consider a job with your organization. A job description sets expectations for both the organization and the candidate. To make sure you hire someone with the level of expertise your practice needs, it’s important to list the certification level and credentials you’d need for this role.
As different certifications are earned through studying and proving expertise in different aspects of specialized and general coding knowledge, you should formulate the job description accordingly but also consider asking candidates to take a coding test. A simple test with an answer that includes rationale, like a coding case, can illustrate a candidate’s critical thinking skills and ability to defend the condition they’re trying to capture with their code selection, Bumford said.
Once you’re at the interview stage, you need to know what the role may entail so you can design an interview appropriate to the skills and interactions needed. When hiring a coder or auditor, a one-on-one interview with a practice manager could be fine, but if the role may involve educator responsibilities, then a panel interview may be a more effective strategy.
“If you’re applying for an educator role, it’s very important that you have the skill set right, that you’re comfortable speaking in front of people,” Bumford said.
With these interviews, she said she sometimes gives candidates two or three slides a few days beforehand, and then they present to the panel. “What I’m looking for is that they’re just not regurgitating or memorizing the slides that I gave them; that they actually did their research and can speak to what’s not on the slide,” she said.
Top tip: Try to see how much a candidate can think on their feet. “What I’m looking for is, if they say: ‘You know what, I don’t have the answer right now, but I’m going to get back to you. I’m going to take it back to the coding team,’” she said. She tells her educators to please be honest if they don’t have an answer, because if they provide the wrong information, they can lose their credibility.
Make Onboarding Comprehensive and Efficient
When you’re onboarding a new employee, you need to make sure you cover all the bases for both the role and the organization. Bumford suggested that your onboarding process covers coding book[s], internal coding guidelines with acknowledgement signature, new hire training document, AHA Coding Clinic, medical record reviewer guidance, Office for Inspector General (OIG) published reports, and Department of Justice (DOJ) filings.
Making sure the new employee has the coding books they need to do their job is crucial. Educating them about the internal coding guidelines is also important. Having the employee sign and date their acknowledgement of reading such a document can prevent future headaches by making sure employees are aware of guidelines and expectations from the start, Bumford said. Similarly, a new hire training document sets expectations from the outset, and having the new employee sign the document as acknowledgement puts everyone on the same page.
Help your new employee do their job to their best of their ability by making sure they’re aware of available resources. This can include AHA Coding Clinic issues, reports published by the OIG, fillings from the DOJ, and other reports or information from other state and federal agencies and departments.
“They will go into detail about what they’re looking for, how they’re interpreting the guidelines. It’s a lot of information there that only helps your team if you talk about it and discuss it. You want to make a well-rounded coder — this is what they need,” she said.
Set Up Your New Hire — and Practice — for Success
If you don’t already have a quality assurance team, you should start one, she said. With a new coder who may not have a ton of experience with something like risk adjustment, having an established mechanism for providing feedback can help the new hire (and practice) thrive.
“That’s where you catch if they’re misinterpreting a process document, if they’re not understanding something in their internal coding guidelines. If there’s an issue, you’re able to address it, and they’re not making the same mistake for weeks,” she said.
Use some kind of quantitative metric to evaluate the coder (or anyone else) so you can easily measure how they’re doing and have the means of knowing when to intervene with more education to bolster quality. Even if you feel like you or your practice doesn’t have the bandwidth for this kind of intensive evaluation and sharing of feedback, quality assurance is a crucial step in not shortchanging your team. Documentation is important for this kind of behind-the-scenes employee management, too, as well as consistency and process standardization.
Building the foundation of your hiring and onboarding processes with this information in mind can help you engage and retain the experts you need to make sure your in-house coders are the resource you practice can depend upon.
Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC
