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August 4, 2008

Shaking Down the Money Tree
By Juliann Schaeffer
For The Record
Vol. 20 No. 16 P. 18

Find out who’s making what in FTR’s 2008 HIM Salary Survey.

HIM professionals are branching out, according to For The Record’s biannual HIM Salary Survey. While slightly less than one half of respondents work as HIM directors (21%) and in-house coders (23%), mirroring our 2006 survey findings, many more professionals are finding work in less traditional arenas.

“There are variations in jobs [out there],” says Claire Dixon-Lee, PhD, RHIA, FAHIMA, vice president of accreditation and education at the AHIMA, citing HIM professionals who work at Walgreens with data analytics. She notes that she is seeing recent graduates grab on to “many more diverse opportunities for work beyond the traditional hospital HIM department. And those types of nontraditional employers are beginning to see the need as well to hire such folks all over [the United States].”

Hospitals and acute care settings are still the most likely place to find HIM professionals, with 65% of respondents working in this setting, but nontraditional HIM workplaces such as law firms, research centers, and software development companies are also popping up.

Ninety-three percent of our respondents were female, and professionals from across the United States completed the survey.

Respondents demonstrated a range of compensation levels—both hourly and annual—with a wide array of HIM job titles. Salary information for the most cited jobs (HIM directors, in-house coders, in-house transcriptionists, and transcription managers), as well as years of experience, credentials, and workplace broken down by geographic region, can be reviewed on the following pages.

For some respondents, more years of experience equaled a larger salary than their counterparts with less time in the industry. But in other instances, the opposite proved true. Dixon-Lee says experience and education are typically the two biggest predictors of salary. “Years of experience obviously play a lot into some levels of salary. If you don’t have the experience, get the education; it goes hand in hand,” she says. “It looks as though additional credentials also give people a little more bargaining power for salary, especially those with less experience. If you get the credentials, that does help to add to credibility.”

Sheri Poe Bernard, CPC, CPC-H, CPC-P, vice president of member relations at the American Academy of Professional Coders (AAPC), says coders should seek credentialing to earn a higher paycheck. “Coders earn 17% more if they are credentialed, according to AAPC’s own survey, which was released in October 2007,” she says. A seemingly puzzling finding from the survey was the even split (as in our 2006 survey) between those who feel opportunities in the field are plentiful (55%) and professionals who believe job opportunities are scarce (45%).

However, these numbers don’t shock Bernard. “It’s no surprise that the issue of coder shortages is sharply divided,” she says. “There seem to be pockets in this country where coders cannot find jobs no matter how qualified they are, while at the same time other parts of the country cannot find qualified coders to fill their job openings. It’s a strong argument for virtual offices.”

Dixon-Lee says the issue is likely regional. “It’s pretty obvious that the people not wanting to change jobs very often, those may be the same people who feel that job opportunities are scarce,” she says.

Not so startling was the roughly one third of survey respondents who cited HIT issues, namely having to do with electronic health records (EHRs) and electronic medical records (EMRs), as the No. 1 challenge in the HIM department and field.

“Implementation of electronic health records is disruptive to normal work processes; that can be very frustrating,” says Dixon-Lee. “There’s not too many ways around that other than trying to identify work patterns that allow you to spend time to adequately work with an implementation.”

She says if EHR systems aren’t working properly or cause a disruption in the workflow, HIM professionals should join in the decision making, implementation, trouble shooting, and continual maintenance and improvement. “HIM professionals really know the workflow, so their role is critical to make those implementations at least a little more improved than what we tend to see from the industry,” she says.

While Dixon-Lee admits that change is disruptive for anyone, she says adapting to a transient work environment is simply part of HIM professionals’ job descriptions, and “you need to learn and keep abreast of all the changes that are happening. Healthcare is evolving, the industry is evolving, and technology continues to evolve faster than we can keep pace.”

“Evolve!” is Bernard’s advice for coders who feel the crunch of changing processes and regulations. “That’s the most important task for HIM workers who want to remain in this field. It’s changing so rapidly, we all need to be willing to wear new hats and learn new skills. Coders need to broaden their interests and their influence. One of the biggest problems I’m seeing with EMRs is that the coding experts are being omitted from the purchasing decision. If you don’t have coders involved in the plan, don’t be surprised when it’s a problem upon execution of that plan,” she says.”

“Target areas where you think you personally need to strengthen your own knowledge as you can see your job changing,” says Dixon-Lee. “Ask what can you anticipate and where can you go for additional professional development. Is it formal education? Is it really picking and choosing the seminars and conferences that you go to that will add more to your battery of abilities and expertise?”

After all, she says more change should be expected in the industry for the coming years. “I think it’s going to become even more rapid. There’s so many starts and stops with electronic health records and health information technology issues that the industry scrambles to try to make improvements,” she says.

A new addition to this year’s survey was a question regarding HIM professionals’ willingness to adopt one of those new technologies—personal health records (PHRs). Twenty-three percent of respondents maintain a PHR, which Dixon-Lee finds promising. “That’s a quarter of the population, and these are people who are in the know. And the fact that 61% were interested in actually establishing one is probably a very good point,” she says, adding that she believes those numbers will continue to increase.

Another change found in this year’s survey centered on industry recognition. In our 2006 survey, 18% of respondents cited respect and recognition in the industry as a challenge, with only 10% citing the concern this year. “Administrators and providers are increasingly aware of the importance of proper coding, billing, and health information management due to the increased regulatory pressures they face. This appreciation will continue to grow as the RAC [recovery audit contractor] program gains momentum and practices see how important coding compliance has become,” says Bernard.

Whether seeking new challenges or higher compensation, Dixon-Lee says branching out and knowing your strengths could find you a better paycheck. “It’s about looking at positions in an area that you’re interested in; they may not state an HIM professional, but you might find that there’s some very good jobs that you fit into and they’ll be surprised to find you,” she says. “I think it’s always a challenge to sell yourself into new roles, and I see a lot of new graduates doing just that.”

— Juliann Schaeffer is an editorial assistant at For The Record.

Salary Survey Results:
Him Directors
In-House Coders
Additional Salary Survey Results