Three Ways to Address Coding and Billing Staff Challenges

Healthcare organizations have found it increasingly challenging to hire and retain qualified medical coders and billers in the past years, and the pandemic has exacerbated this problem. Ingenious Med’s Brian Cregan, Vice President of Customer Success, and Bryan Goble, CPHIMS, Director of Product Management, discuss some of the factors behind this trend and propose three ways to address it.

Factors Behind the Coding and Billing Staff Shortage

One factor driving coding and billing shortages was that it has become more complex. The move to ICD-10 in 2015 more than quadrupled the number of healthcare codes and necessitated that professionals train in specific, focused areas. The U.S. Bureau of Labor Statistics estimates that the demand for medical record specialists and coders will grow at an annual rate of 9% from 2020 to 2030.

A more recent factor is the pandemic. The ‘Great Resignation’ during COVID has had a significant impact on the availability of RCM staff. A recent HFMA survey of CFOs reports that half of respondents say it’s harder today to find qualified revenue cycle workers.

physician typing on laptop computer

Cregan said, “The turnover rate among billers and coders has escalated. Our customers report that it’s more expensive and more challenging to recruit revenue cycle staff, making it all the more important to have tools that make your RCM operations more efficient and scalable with the resources they have today.”

The challenges are occurring amid growing scrutiny of healthcare billing practices by the federal government, making it imperative that healthcare organizations ensure that their billing practices don’t sacrifice quality or compliance to collect revenues.

Three Ways to Address Medical Coding and Billing Challenges

According to Cregan and Goble, healthcare organizations can take three steps to mitigate this problem:

  1. Do more with less – use mobile tools that make it easy for physicians and clinicians to quickly capture simple, compliant charges at the point of care and reserve coders for more complex cases. The solution should also be able to rapidly adapt to coding changes, such as those engendered by new telehealth or COVID codes, or new E/M rules. A growing number of physicians have embraced this process because they realize the right tool can help them reduce or eliminate the back and forth coding query process, help their practice realize more revenue, and ensure that they’re getting credit for their productivity.
  2. Improve wages and job satisfaction — point of care tools can enable organizations to reduce or redeploy staff so that dollars are available to pay their remaining staff higher wages. Such tools can also reduce rework caused by errors and free employees to perform more interesting work, which can in turn boost satisfaction and/or attract more skilled staff.
  3. Encourage remote work – organizations can cut costs on office space and infrastructure when more staff can work from home all or some of the time.

How Point of Care Solutions Mitigate RCM Staff Challenges

The average salary for a coder is about $20 per hour (over $40,000 a year) and that doesn’t account for the additional costs of hiring, training, replacing, or providing benefits to those workers. Experienced coders and coders in some areas of the country earn over $60,000 per year. Health systems and practices can reduce these costs by using charge capture tools that physicians can use at the point of care.

Goble explained, “While billing and coding does not require a college degree, it usually requires a professional certification and can be quite complex depending on the medical specialty and types of services being covered. The top tier billers and coders can cover a wider array of specialty coding and coding processes but there’s still a high degree of variability from one coder to the next.”

Ingenious Med helps scale by giving physicians the resources to accurately and completely capture charges at the point of care in a few seconds. That enables coding and billing staff to spend their time elsewhere or use fewer resources.


He continued, “Ingenious Med helps scale by giving physicians the resources to accurately and completely capture charges at the point of care in a few seconds. That enables coding and billing staff to spend their time elsewhere or use fewer resources. They can instead focus on more complex bills where their knowledge and education are more critical or perform other critical tasks, like auditing. Organizations realize increased revenue recognition, FTE reduction, and faster reimbursement when coders and billers don’t have to intervene to create or review charge claims.”

Cregan contributed, “We see ongoing communication between revenue cycle leadership and physicians as a best practice for maintaining organizations’ financial health. Having everyone understand the organization’s criteria for financial success and their role in achieving those goals is key to appreciating how automation can change the business for the better.”

Charge Capture is Effective Whether Insourcing or Outsourcing

Cregan noted that outsourcing has been used by some clients to address shortages. “That means foregoing roughly 6% of every collection that’s handled by that outsourcing entity. That said, we do partner with many billing companies, which recognize that clients’ charges come in cleaner, faster and more reliably when they use Ingenious Med, saving overhead for everyone without increasing the risk of audits.”

Standardization: The Key to Revenue Integrity and Scaling Efficiently

Point of care tools also facilitate organizations’ ability to efficiently scale RCM as they grow. Goble stated, “If you don’t allocate the right number of coders as you add staff, you could create a coding bottleneck, lose remaining staff to burnout, lose revenue associated with denied and unbilled services, increase risk—or all of the above. In today’s environment, it’s critical to have a consistent revenue cycle operation that can support the additional practices that are being absorbed without having to directly scale up. Using the right charge capture solution makes that possible.”

Goble shared some examples of how Ingenious Med’s customers use the solution to scale. “For example, when a large for-profit national physician organization absorbed another company in 2015, they centralized much of their billing functions with minimal additional FTEs. Similarly, a national health system has deployed Ingenious Med in most new markets to standardize practices and gain economies of scale.”

physician typing on mobile phone

He added, “Another example is a large not-for-profit health system that uses us when they launch a new practice or buy a practice. They turn us on to get the practice up and running quickly, with standardization of work effort by end user physicians across multiple specialties.”

Cregan contributed, “Standardization is important because there’s significant variance in coding knowledge, expertise, and efficiency. With that variation comes exposure, so if you have a coder that is generating unjustifiable charges on behalf of a doctor, you’re creating liability for the doctor and the employee’s healthcare organization.”

While medical billing and coding staff challenges are long standing, the pandemic highlighted how critical it is to address them. Physician practices and healthcare systems that acquire point of care solutions that expedite these functions and reduce the need for increasingly expensive staff are the ones most likely to thrive going forward. Fortunately, more and more physicians every day understand what is needed to make their businesses profitable and manage cashflows.