Top Skills Every Clinical Coding Associate Should Master

Medical coding, a highly sought-after field of the evolving healthcare industry, significant in ensuring quality processes leading to a gratifying revenue level, has been in increasing demand specifically for credentialed, experienced clinical coding associates adequately to handle the intricate job. According to the U.S. Bureau of Labour Statistics, the number of medical record specialists is anticipated to grow 8 percent between now and 2032. The unprecedented demand for never-ending updates and technological advancement are other considerable factors for clinical coders to keep learning and mastering the skills needed for maintaining the accuracy of patient records, complex billing, and compliance requirements with current standards. No doubt, every professional needs skills relevant to work efficiently, just like Clinical Coder associates must know about the software they use in coding according to the International Classification of Diseases-ICD and Current Procedural Terminology regulations. These skills are essential but only partially support a coder's compliance with the overall professional work achievement. Along with professional skills, soft skills are helpful to entry-level coders or associate coders and experienced coders to achieve bigger targets.
Let's explore the increasing demands and requirements of fulfilling the medical coder skills checklist, including soft and professional skills in this modern world essential to balancing quality and revenue for healthcare organizations and providers in this article.

Automated Clinical Coding: The Need Of Today's Medical Coders

The term “automated clinical coding" isn't new in the industry and in streamlining various complex tasks for providers and practitioners. Advancement in automation for multiple processes, including medical coding, assists providers in transforming medical information into an electronic patient record. The manual method of medical coding is a time-consuming task and requires professionals to fulfill a standard for acquiring a high level of accuracy. However, AI-based and natural language processing NLP automation is at pace to relieve medical coding associates burdens by improving the precision and efficiency of coding. One of the main reasons coders choose automated or computerized coding systems is that manual coding takes a lot of time for practitioners, especially when you take into account the situations that coders must code on a daily basis. For instance, a coding department for the NHS with 25–30 coders typically codes over 20,000 cases each month; however, a backlog of cases needs to be coded, which takes even longer.
The need for automated clinical coding is further justified by the fact that manual coding frequently results in errors because of missing patient information, subjective diagnosis code selection, a shortage of coding specialists, and data entry errors. For example, coding accuracy in the United Kingdom ranges from 50 to 98%, averaging 83%. In Scotland, the ratio is high, reaching 92.5% for 3-digit code accuracy and 88.8% for 4-digit code accuracy during the 2019-2020 assessment. Despite this, perfection remains elusive, and under-coding persists, influencing around 20% of prevalent conditions. However,computer-assisted coding improves the quality, accuracy, and efficiency of coding as per the recent data and better support for medical coding associated with current A.I. technologies.

What Expertise Do Clinical Coding Associates Need To Utilize The Technology?

Efficient engagement with these systems needs the expertise and training of clinical coders to witness outcomes. Reviewed by Campbell and Giadresco, deploying an AI-based tool into a clinical coding environment poses some technical and organizational challenges, for which it is essential for coders to be involved in the model development and deployment stage. Deep learning and understanding are needed to integrate these systems in coding more inherently. Moreover, clinical coding associates must know their changing roles, e.g., from coders to editors and coding analysts, as learning automated clinical coding emerges as one of the soft skills for medical billing and coding.

Professional Skills

Educational and Certification Qualification

First, a coder in clinical coding must have professional qualifications and certification approved by the American Academy of Professional Coders (AAPC) certification. Professional certification through an American-recognized institution will enhance the professional expertise of the associate, which will be helpful for coders to perform efficient work coding. Education gives the confidence and professional knowledge essential to enter any company or organization. Clinical coders must get professional education and relevant certification to get a chance to be hired as a priority.

Knowledge of Anatomy and Physiology

Every essential medical diagnosis is based on anatomy and physiology, terms or areas used in medical diagnoses; anatomy refers to the internal and external structure of the human body and its physical relationship, whereas physiology denotes the functions of these structures. An associate must recognize these body structures or parts and their functions better to understand medical or clinical diagnoses for accurate coding. The knowledge of anatomy and physiology is the basic foundation to excel in the medical and healthcare field and is helpful to recognize or remember medical terminologies.

Familiarity with Coding Software

With the rise of technology and digital systems, a coding associate must be familiar with and know how to use different software for accurate coding and reimbursement claims. Clinical coders must keep themselves up to date regarding the latest coding software as this software is helpful for precise coding and makes reimbursement claims successful. XIFIN is a digital and artificial intelligence-focused revenue cycle management software that is helpful in workflow and accounts receivable processes. This system regulates and enhances the accounts receivable process, management, and financial reporting. A clinical coding associate must be aware and have efficient knowledge of the XIFIN billing system for better coding.

Skills in Research and Analyzing Data

Coding associates can enhance their performance excellently if they have excellent research skills and can analyze the data found during the research. A good knowledge of performing research on all the skills to keep themselves updated about changes in policies, regulations, and coding systems or processes will enable coders to perform excellent work in coding. A coding associate must have research and analytical skills to handle or solve problems from multiple angles. Analytical skills are helpful for coding associates to analyze medical records and insurance claims to identify errors and discrepancies.

Computer Skills

Basic knowledge of computers and how to work with different software and programs such as MS Word, MS Excel, and other coding software. A clinical coder must be aware of digitalized healthcare systems like the Electronic Healthcare Record system. He must have a suitable typing speed to complete the task within a timeframe. He must be familiar with new software updates and how to use them.

Other Top Skills Every Clinical Coding Associate Should Master

Understanding Of Medical Terminology

In order to assign appropriate codes to each procedure and diagnosis, medical coders need to have a thorough understanding of medical terminology, which will allow them to identify codes and their assignments quickly. As the foundation of medical coding, coders must know the language used in healthcare procedures, including physiology, anatomy, pharmacology, and common diseases and medical procedures.

Clinical Coding Associate's Capability Of Adapting New Technologies

Success is determined by being innovative and competing across different technological equipment in healthcare, and professionals must ensure adapting computer skills needed for medical billing and coding. The healthcare industry is at pace with advancing tools and technologies. Hence, coders must be adept at operating platforms to meet the needs of unique organizations and varying software according to the demands. Various technologies used in medical coding include Microsoft Office, ICD-10-CM and CPT navigation tools, healthcare systems for medical billing and coding, and document management software that require coders to master their integration.

ICD-10 And CPT Code Set

The intricate job of a medical coder requires converting sensitive patient data into standard codes that are universal in the healthcare industry and further proceedings specifically to maintain the financial stability of organizations. Coders must pay attention to proficiency in the ICD-10 Coding system 10th to 11th Edition and Current Procedural Terminology CPT Codes. Having mastery over these standard code sets and their updated versions will help practitioners accurately record and utilize the data for accurate reimbursement.

Effective Communication Skills

Clinical coding associates come across many encounters with care providers, insurance companies, and patients. Practical communication skills for medical coders are crucial to avoid many coding and billing discrepancies because it will help them clarify the coding procedures and billing information to staff and insurance payers. Furthermore, effective communication can become an essential tool to get patients satisfied when knowing their billing information.

Ethical And Legal Compliance

The healthcare industry is responsible for various procedures to maintain quality and revenue. Amidst those are keeping patient records accurate and confidential from fraudulent activities. Medical coders must adhere to strict rules in coding and ethical and legal standards, including the Health Insurance Portability and Accountability Act (HIPAA), to ensure that patient records comply with standard regulations. However, maintaining the practice according to ever-evolving policies, regulatory laws, and codes leaves professionals unfilled when it comes to keeping practice compliant because non-compliant practice can only hinder the organization's cash flow and reputation.
Here are some compliant coding best practices to stay on track while optimizing reimbursement for the services delivered.
Improve The Quality Of Clinical Documentation - A recent study found that EHR documentation and what happened in a clinical encounter only resembled each other between 38% and 53% of the time. Hence, healthcare systems must focus on investing in the clinical documentation quality manager to ensure the coding's role in compliance.
Technological Integration In Coding And Compliance - Considering the healthcare industry becoming more digitized, such as streamlining and optimizing claims management and reimbursement. Moreover, computer-assisted coding solutions CAC take information from patient records and transfer these to coders, demanding clinical coding associates to be adept and efficient at integrating innovative coding software.
Ongoing Education And Training - In order to break the barriers between coders and clinical documentation improvement specialists and providers and staff, there is a need for continuing training and education for providers to understand the specific way of documenting. Moreover, the ever-changing rules of the healthcare industry demand providers to keep their practice fresh while keeping updated on the changes in coding guidelines, regulations, and advancing technology through education.

Ethical And Legal Compliance

Intensify Your Medical Coding Skills Resume With MedsIT Nexus Medical Billing and Coding Guide

Grab the opportunity to be the essential unit of clinical coding in healthcare. Various medical coding courses and certifications will help you keep exploring and catering to your curiosity of learning to overcome the challenges of ever-evolving fields. MedsIT Nexus Medical Billing and Coding guide will also help you decide efficiently for a grooming career and how to strategize your objective for a medical coder resume. However, choosing medical coding as a career requires committing to accuracy and ethical conduct to flourish in a rewarding profession. Hence, earning both soft and hard skills for medical billing and coding will pave the way for you to enter into the territory of various medical coding jobs in healthcare.