What can you tell me about meding coding and the HIM field

martymoose, BSN, RN · May 22, 2014

All I can say is that in my area it only pays around 12 bucks an hour. Otherwise I was going to go back to school for that.

applejackcrunch · May 22, 2014

Hi dulcet,

I would say this board would be a good place to ask mostly because HIM and nursing can be combined in a number of ways. I don't know what your background is (student, graduate, RN, etc) but HIM can be a good area to get into if you enjoy more of the behind-the-scenes stuff rather than actual patient care time.

Medical coding is largely moving toward remote access thanks to more facilities moving to electronic health records systems. For this kind of job you have to be organized and willing to continue your education and hold certifications (RHIT, CCS, CPC, and so on). Check out AHIMA for more information on what is needed for certification. Most coders hold an AAS or AS in health information, though you can possibly get a job with the right background (working in a medical office for 5+ years, for example) with only a certificate program. Inpatient coders generally have the most experience and of course, highest pay. Outpatient coders can usually be hired with about 2 years of coding experience plus a degree along with RHIT / CCS certification. They'll make a bit less than inpatient coders. Some facilities will hire entry level coders who have just graduated from a 2 year program for radiology, lab, PT, and infusion coding. Entry level positions, depending on the location, will probably make about $12-15 an hour. Inpatient coders can make, just a guesstimate based on what I've seen, about $19-22 an hour depending on experience and the level of expertise. RHIAs are only certified when they have a B.S. or B.A. I've only seen RHIAs in management positions, in both coding and HIM. I'm sure those people would make around $45-60k per year based on experience/background and location.

HIM positions with duties like scanning and analyzing patient records can depend on the needs of the facility... I've seen some places that want their HIM employees who are doing analyzing records to hold RHIT degrees. I interned at a department that has no requirements other than having the necessary skills and applicable experience. These positions will make anywhere between $10 and $20 per hour but it's important to note that these types of positions don't normally have high turnover rates, especially in less populated areas. It will be harder to find jobs in these categories, though they are out there.

If you're thinking about how nursing can connect with these fields, many facilities are developing clinical documentation improvement programs that are aimed at helping doctors become more clear in their documentation for the ease and clarity in coding. It's becoming extremely important with the oncoming ICD-10 train that will (hopefully, finally) pull into the station in October 2015. You could also get into quality improvement and utilization review, which often connects with HIM departments for a variety of reasons. And of course I'm sure there are plenty of other connections, but just to keep things as short as possible, those are the more commonly known positions that came to my mind first.

And for what it's worth... I just graduated from a health informatics and information program with an AAS. I decided to continue on to an ADN program because I know that getting into coding and HIM would make me completely miserable. I've found that there's very little interpersonal connection made and sitting in a cubical (or at home) for 8 hours each day just sounds awful to me. Yes, compassion and caring are necessary traits for any position taken in healthcare, but HIM staff are pretty much stowed away from all of the "action" that goes on. If that wouldn't bother you at all, I would suggest you give it a try! You can learn a lot in an entry level position.

dulcet · May 25, 2014

Hi dulcet,
I would say this board would be a good place to ask mostly because HIM and nursing can be combined in a number of ways. I don't know what your background is (student, graduate, RN, etc) but HIM can be a good area to get into if you enjoy more of the behind-the-scenes stuff rather than actual patient care time.
Medical coding is largely moving toward remote access thanks to more facilities moving to electronic health records systems. For this kind of job you have to be organized and willing to continue your education and hold certifications (RHIT, CCS, CPC, and so on). Check out AHIMA for more information on what is needed for certification. Most coders hold an AAS or AS in health information, though you can possibly get a job with the right background (working in a medical office for 5+ years, for example) with only a certificate program. Inpatient coders generally have the most experience and of course, highest pay. Outpatient coders can usually be hired with about 2 years of coding experience plus a degree along with RHIT / CCS certification. They'll make a bit less than inpatient coders. Some facilities will hire entry level coders who have just graduated from a 2 year program for radiology, lab, PT, and infusion coding. Entry level positions, depending on the location, will probably make about $12-15 an hour. Inpatient coders can make, just a guesstimate based on what I've seen, about $19-22 an hour depending on experience and the level of expertise. RHIAs are only certified when they have a B.S. or B.A. I've only seen RHIAs in management positions, in both coding and HIM. I'm sure those people would make around $45-60k per year based on experience/background and location.
HIM positions with duties like scanning and analyzing patient records can depend on the needs of the facility... I've seen some places that want their HIM employees who are doing analyzing records to hold RHIT degrees. I interned at a department that has no requirements other than having the necessary skills and applicable experience. These positions will make anywhere between $10 and $20 per hour but it's important to note that these types of positions don't normally have high turnover rates, especially in less populated areas. It will be harder to find jobs in these categories, though they are out there.
If you're thinking about how nursing can connect with these fields, many facilities are developing clinical documentation improvement programs that are aimed at helping doctors become more clear in their documentation for the ease and clarity in coding. It's becoming extremely important with the oncoming ICD-10 train that will (hopefully, finally) pull into the station in October 2015. You could also get into quality improvement and utilization review, which often connects with HIM departments for a variety of reasons. And of course I'm sure there are plenty of other connections, but just to keep things as short as possible, those are the more commonly known positions that came to my mind first.
And for what it's worth... I just graduated from a health informatics and information program with an AAS. I decided to continue on to an ADN program because I know that getting into coding and HIM would make me completely miserable. I've found that there's very little interpersonal connection made and sitting in a cubical (or at home) for 8 hours each day just sounds awful to me. Yes, compassion and caring are necessary traits for any position taken in healthcare, but HIM staff are pretty much stowed away from all of the "action" that goes on. If that wouldn't bother you at all, I would suggest you give it a try! You can learn a lot in an entry level position.

Wow I can't tell you how much I appreciate this reply. Are you telling me that even after I get a AAS and become a RHIT I would start off at 12 per hour and have a hard time getting a job. That is a little depressing. And after 4-5 years and rhia I could potentially make 45-60k? Thank you for your time.

dulcet · May 25, 2014

All I can say is that in my area it only pays around 12 bucks an hour. Otherwise I was going to go back to school for that.

Yeah I can't blame you. That is barely above minimum wage. Sigh

dulcet · May 25, 2014

All I can say is that in my area it only pays around 12 bucks an hour. Otherwise I was going to go back to school for that.

The strange thing is I've seen job listing for much higher wages after 5-4 years of experience. Idk this is so confusing.

dulcet · May 25, 2014

Hi dulcet,
I would say this board would be a good place to ask mostly because HIM and nursing can be combined in a number of ways. I don't know what your background is (student, graduate, RN, etc) but HIM can be a good area to get into if you enjoy more of the behind-the-scenes stuff rather than actual patient care time.
Medical coding is largely moving toward remote access thanks to more facilities moving to electronic health records systems. For this kind of job you have to be organized and willing to continue your education and hold certifications (RHIT, CCS, CPC, and so on). Check out AHIMA for more information on what is needed for certification. Most coders hold an AAS or AS in health information, though you can possibly get a job with the right background (working in a medical office for 5+ years, for example) with only a certificate program. Inpatient coders generally have the most experience and of course, highest pay. Outpatient coders can usually be hired with about 2 years of coding experience plus a degree along with RHIT / CCS certification. They'll make a bit less than inpatient coders. Some facilities will hire entry level coders who have just graduated from a 2 year program for radiology, lab, PT, and infusion coding. Entry level positions, depending on the location, will probably make about $12-15 an hour. Inpatient coders can make, just a guesstimate based on what I've seen, about $19-22 an hour depending on experience and the level of expertise. RHIAs are only certified when they have a B.S. or B.A. I've only seen RHIAs in management positions, in both coding and HIM. I'm sure those people would make around $45-60k per year based on experience/background and location.
HIM positions with duties like scanning and analyzing patient records can depend on the needs of the facility... I've seen some places that want their HIM employees who are doing analyzing records to hold RHIT degrees. I interned at a department that has no requirements other than having the necessary skills and applicable experience. These positions will make anywhere between $10 and $20 per hour but it's important to note that these types of positions don't normally have high turnover rates, especially in less populated areas. It will be harder to find jobs in these categories, though they are out there.
If you're thinking about how nursing can connect with these fields, many facilities are developing clinical documentation improvement programs that are aimed at helping doctors become more clear in their documentation for the ease and clarity in coding. It's becoming extremely important with the oncoming ICD-10 train that will (hopefully, finally) pull into the station in October 2015. You could also get into quality improvement and utilization review, which often connects with HIM departments for a variety of reasons. And of course I'm sure there are plenty of other connections, but just to keep things as short as possible, those are the more commonly known positions that came to my mind first.
And for what it's worth... I just graduated from a health informatics and information program with an AAS. I decided to continue on to an ADN program because I know that getting into coding and HIM would make me completely miserable. I've found that there's very little interpersonal connection made and sitting in a cubical (or at home) for 8 hours each day just sounds awful to me. Yes, compassion and caring are necessary traits for any position taken in healthcare, but HIM staff are pretty much stowed away from all of the "action" that goes on. If that wouldn't bother you at all, I would suggest you give it a try! You can learn a lot in an entry level position.

Also would you recommend that I try to get degrees in both nursing and him? Clinical improvement specialist sounds like something I would be interested in. I hope the pay gets much better after the entry level positions.

applejackcrunch · May 26, 2014

Wow I can't tell you how much I appreciate this reply. Are you telling me that even after I get a AAS and become a RHIT I would start off at 12 per hour and have a hard time getting a job. That is a little depressing. And after 4-5 years and rhia I could potentially make 45-60k? Thank you for your time.

Also would you recommend that I try to get degrees in both nursing and him? Clinical improvement specialist sounds like something I would be interested in. I hope the pay gets much better after the entry level positions.

Well, the thing about HIM positions is that A) pay is relative to facility size and type. So for example, at a large facility in a metro area you might start out at $14-15 an hour for entry level stuff. Coding, on the other hand, would start somewhere around $20-22 an hour (with an RHIT and CCS, because certifications are usually a big deal at these places and they want you to have them beforehand). Smaller hospitals in smaller cities will, of course, bring less pay. B) Once you get into a facility it can be pretty easy to move up the ranks. No guarantees, but I've seen people rise up to a higher paying job ($2-3 / hour higher) within six months or a year, starting from the bottom. C) This field is always changing. You're going to see new kinds of positions pop up with new technologies or systems or theories- like documentation improvement- and later on... they might be cut back or eliminated completely. Getting the higher degree and certification- B.S. with RHIA cert- will offer you more... well, I'll say room to grow within the field. But that doesn't mean that while you're in school you shouldn't be working somewhere part time in that entry level position to work your way up. That experience will only beef up your resume and increase the chances of you earning higher pay later on based on experience. Clinical documentation improvement is not an entry level position at all, though. Most places want 5+ (if not more, I've also seen organizations asking for a decade or more) years of experience in nursing or inpatient coding- meaning more certs and much more time in the position- because it requires a higher level of knowledge that only comes with experience.

As for degrees in nursing and HIM... it depends on what you want to do. Search around a bit and look at some job descriptions for nurses in all kinds of positions and do the same for HIM. You might find that some jobs catch your eye more than others and those might guide you toward the kind of education you want to get.

But if I might make a suggestion... don't worry so much about pay. I realized early on that the work in HIM and coding would make me miserable and that is why I'm following my dream to become a nurse now after so many years of fighting it. Find something that you know you would be happy doing and go from there.