Building a Talent Pipeline

In News by Sue Taylor

Building a Talent Pipeline: AHIMA Foundation Apprenticeships Help Connect Prospective HIM Professionals with First-time Jobs

By Lisa A. Eramo, MA

Like many new HIM graduates, Makema Hopes, RHIT, began looking for a job immediately after receiving her associate’s degree in 2011. She thought her 80-hour internship at a local hospital prepping and scanning charts would surely help her get her foot in the door with an employer and land an entry-level coding position. However, she quickly realized this wasn’t the case.

“It’s so hard to break into this field with no experience even when you have a degree and certification,” Hopes says. “Nobody would take a chance on allowing me to code.”

At first, Hopes thought relocating to a different state would help open the doors of opportunity. But even after moving from South Carolina to Oklahoma, she continued to struggle with finding an employer who would hire her as a coder. It wasn’t until she moved to Florida in 2015 that her coding career finally began to take off. That’s when she joined Tampa General Hospital as a medical coder apprentice—one of dozens of apprentice opportunities created as part of a federally-funded AHIMA Foundation apprenticeship program.

“It’s an opportunity of a lifetime,” says Hopes, who will complete the one-year apprenticeship program in July. “Somebody is willing to take a chance on you, hope you grasp the information, and pay you to do it.”

The opportunity came at a time when Hopes felt as though she had exhausted every other option. “They invested in me when I had nothing. This actually makes me work harder,” she says.

Hopes wants to eventually obtain her CCS credential and work as a remote coder with a long-term goal of becoming an auditor. She says the variety of chart types she is coding in the apprenticeship program gives her an advantage over her peers. “When you’re exposed to all of these chart types, it makes you more marketable,” she says.

Want to Hire an Apprentice? What Employers Need to Know

What Organizations Can ParticipateAny provider that employs HIM professionals can participate in the program. This includes—but is not limited to—coding vendors, consulting firms, electronic health record or health IT vendors, acute care hospitals, long-term care hospitals, inpatient rehab facilities, behavioral health facilities, and physician practices.

How to ApplyEmployers interested in applying for the AHIMA Foundation apprenticeship program can follow these steps:

  1. Identify the apprenticeship role(s) in which you’re interested as well as the timeline for filling each position. For example, do you need an inpatient coder? An outpatient coder? Both? Note that registering with the US Department of Labor could take six to eight months, depending on the size of the organization, says Deborah K. Green, MBA, RHIA, executive vice president, chief innovation and global services officer at AHIMA. This is due to the complexity of the program’s requirements and standards, both of which often require legal review.
  2. Complete a short online survey so the AHIMA Foundation can learn more about your organization’s needs and follow up on the program. The survey is available at www.surveymonkey.com/r/SBK2VZP.
  3. Review potential apprentice cover letters and resumes, both of which are pre-screened by the AHIMA Foundation.
  4. Interview pre-screened applicants and hire one or more apprentices. Employers determine the specific compensation package offered to each apprentice.

What to ExpectOnce you’ve hired an apprentice and completed all paperwork required by the US Department of Labor, you’ll begin the program. First, you’ll schedule the apprentice’s six- to eight-week immersion training using the AHIMA Foundation’s standardized online modules. Then, you’ll provide on-the-job learning for the remainder of the year-long apprenticeship program. The AHIMA Foundation provides ongoing support throughout this process.

What Employers Gain

  • Customized training curriculum developed by the AHIMA Foundation to meet the needs of your organization.
  • Ongoing support from the AHIMA Foundation, including pre-screening of all apprentice candidates as well as weekly progress reports/conference calls to discuss each apprentice’s progress and demonstration of skills.
  • Highly skilled workers who remain loyal to your organization.

To learn more about how employers can get involved, visit www.ahimafoundation.org/prodev/Registered_Apprenticeship.aspx.

Paving a Path for Success

Tampa General Hospital is one of several employers participating in “Managing the Talent Pipeline,” a program operated by the AHIMA Foundation and funded by a $4.9 million grant from the US Department of Labor (DOL). The goal of the grant is to help address the gap between academic training/competencies and the on-the-job skills needed to ensure professionals are ready to enter the workforce.

The apprenticeship program supplements didactic training with vital on-the-job experience that today’s professionals need to launch their careers, says Deborah K. Green, MBA, RHIA, executive vice president, chief innovation and global services officer at AHIMA.

“What we’re trying to do with the apprenticeship program is create situations for those people who are coming out of college with degrees to get the kind of experience and training they need to be workforce-ready,” Green says. “It’s also intended to help those who are working learners to upscale their skills and competencies in order to attain higher jobs, career pathways, and better job opportunities.”

The AHIMA Foundation’s grant is part of a $175 million “American Apprenticeship Grants” program distributed to 46 public-private partnerships that “marry the efforts of employers, organized labor, non-profits, local government, and educational institutions to expand high-quality apprenticeships,” according to a White House press release.

Now that the program is gaining traction, the AHIMA Foundation has placed more than 60 trainees in a variety of healthcare settings. By the conclusion of the grant in September 2020, the AHIMA Foundation hopes to place a total of 1,200 apprentices in the following roles:

  • Hospital coder/coding professional
  • Clinical documentation improvement (CDI) specialist
  • Business analyst
  • Data analyst

“The money ends in four years, but we’re hoping this becomes an ingrained part of who we are in the foundation and what we do,” Green says.

Helping HIM Professionals Excel

Providing an on-ramp for success helps many HIM professionals struggling to break into the field or advance their careers.

Consider Kim Wallingford, RHIT, who worked in the central processing and release of information departments at Tampa General Hospital while completing her associate’s degree. Like Hopes, Wallingford wanted to become a medical coder but couldn’t advance beyond an entry-level HIM position, despite her education and certification.

When the apprenticeship program at Tampa General Hospital became available, Wallingford jumped at the opportunity and says the experience has been invaluable. “You can know all of your guidelines and the fundamentals of coding, but the apprenticeship gave me the confidence in applying my knowledge,” she says.

Both Hopes and Wallingford have already been offered full-time coding positions at Tampa General Hospital.

Want On-the-Job Learning? What Apprentices Need to Know

Who Should ApplyAlthough individuals may initiate an application of interest at any time, candidates may need to have passed a qualifying certification exam, such as the RHIT, RHIA, CCA, or CPC exam, depending on the apprentice type and role.

How to ApplyProspective apprentices interested in applying for the AHIMA Foundation apprenticeship program can follow these steps:

  1. Complete an online apprenticeship interest application at https://app.smarterselect.com/programs/22482-Ahima.
  2. Applications are reviewed based on employers’ hiring needs. If a candidate meets an employer’s qualifications, the AHIMA Foundation may request that he or she participate in a screening interview.
  3. Once the screening call is completed—and the AHIMA Foundation confirms that the candidate meets an employer’s needs—the foundation sends the candidate’s cover letter and resume to that employer for consideration.
  4. Participate in an interview with the potential employer.

What to ExpectIf an employer hires you as an apprentice, you’ll be required to sign an apprenticeship agreement. Next, you’ll complete six to eight weeks of online immersion training through the AHIMA Foundation followed by on-the-job learning from the employer for the remainder of the year-long apprenticeship program. Most employers require apprentices to work onsite for the duration of the program.

If the AHIMA Foundation is unable to make a match with an employer sponsor, don’t give up. “Even if you get denied, try again and keep pursuing it. It may not come up the first time you apply, but don’t give up on trying,” says Kim Wallingford, RHIT, an apprentice at Tampa General Hospital.

What Apprentices Gain

  • No-cost exam for your first attempt at an AHIMA certification based on program requirements.
  • Access to the “Apprentice Engage” online community.
  • Online immersion training and role-specific learning modules.
  • Mentoring through your employer sponsor.
  • A structured training program centering on common employability skills, immersion training, and other specialized training based on the apprentice’s role.

To learn more about becoming an apprentice, visit www.ahimafoundation.org/prodev/apprentice.aspx.

Why Apprenticeships Pay Off for Employers

The AHIMA Foundation’s apprenticeship program does not only benefit HIM professionals. There are also many advantages for employers, one of which is being able to recruit and retain skilled workers.

In the year leading up to ICD-10 go-live, Diane M. Lerch, RHIA, CHPS, CCS, CHC, CHTS-TR, CHTS-PW, director of coding and CDI at Tampa General Hospital, says she began to worry that the hospital wouldn’t have enough coders to make the transition effectively. She was also looking several years beyond ICD-10 to ensure she had a succession plan in place when several long-term coders would likely retire.

The hospital already had an internal coding professional apprentice program in place, but Lerch admits it was difficult to devote time to training individuals with minimal experience. “Our audit educators weren’t just dedicated to the apprentices. They had to educate everyone,” she says.

When the AHIMA Foundation announced its grant award, Lerch immediately saw an opportunity to tap into valuable training resources and augment their internal program. “The foundation was an extension of us providing some of that hands-on training,” Lerch says.

All apprentices must complete six to eight weeks of online immersion training using a curriculum and modules provided by the AHIMA Foundation, followed by 2,050 hours of on-the-job learning and mentoring. Each facility sets its own quality and productivity benchmarks.

The mentoring phase of the program can be daunting because not every organization has enough staff members to provide this level of support. But that shouldn’t be a barrier, Lerch says.

“Even if you need to leverage outside resources to temporarily audit your apprentices, I think in the long run it’s going to be more cost effective to augment your staff with contract labor,” she says, adding that managers must have a long-term strategy in place to fill vacancies.

In addition, employers aren’t required to launch apprentices into a live coding environment right away. At Tampa General Hospital, apprentices begin their on-the-job learning by coding cases that have already been completed. “There’s already an answer key because the certified coder has already completed it,” Lerch says. “If the apprentice came up with a different result, they can discuss this with their audit educator as part of their mentoring and learning process.”

Eventually, apprentices transition to coding live cases, but only after they’ve met certain quality requirements. Apprentices place these cases on hold so a coding mentor can review them. Even if the accounts are not released until the next day, Lerch says the impact to discharged not final billed is minimal.

Four Tips to Obtain Executive Buy-in for an Apprenticeship Program

You want to hire an apprentice, but you need executive buy-in. How can you obtain it? Follow these four tips:

  1. Focus on why apprenticeships are good for the bottom line. Employers that offer apprenticeship programs often experience decreased costs related to employee turnover. “The research definitely shows that individuals who go through apprenticeship programs are definitely more loyal to the organizations. They stay longer and have higher levels of satisfaction,” Green says.
  2. Reiterate why apprentices are good for employee morale. “The coders are actually happy to see that we’re investing in the next generation,” says Diane M. Lerch, RHIA, CHPS, CCS, CHC, CHTS-TR, CHTS-PW, director of coding and CDI at Tampa General Hospital. “It provides our coding team an opportunity to mentor newer members, and it involves them in our succession plan.”
  3. Shape a long-term vision for return on investment. “You’re not going to get an immediate return, but I can honestly say for the apprentice coders we’ve trained… I’ve now got my next generation of coders in the first year, and they’re productive,” Lerch says. “It is part of a long-term strategy, and it’s a more cost effective plan than to deal with the ongoing challenges involved in attempting to fill vacancies.”
  4. Start small, then build from there. “If you want to test out with a proof of concept, start out with one or two apprentices. Do what’s manageable,” Lerch says.

Training the Next Generation of HIM professionals

Trinity Health in North Dakota has also benefited from the AHIMA Foundation apprenticeship program. Like many facilities in rural areas, the hospital simply couldn’t recruit and retain qualified coders. That’s not surprising considering the closest city with an inpatient prospective payment system hospital is more than 100 miles away from Trinity Health. The closest school with an RHIT program is a seven-hour drive away.

“Our pool of candidates was so small,” says Debra A. Boppre, MSM, RHIA, CCS, CCS-P, FAHIMA, enterprise HIM director at Trinity Health. Some of the hospital’s full-time coding positions had already been vacant for more than a year.

When Boppre heard about the AHIMA Foundation apprenticeship program, she knew it would be a good fit for the organization. Trinity Health currently employs two inpatient coding professional apprentices, both of whom are in the immersion training phase of the program.

“We hire the apprentices from the very beginning, but then they get this extra training from the [AHIMA] Foundation that I feel is a huge benefit,” Boppre says. “They get exposure to all different record types and feedback from professionals who are experts. It’s a good, solid training program.”

Boppre says the AHIMA Foundation experts have been very supportive throughout the process. “If we have questions, it’s easy to e-mail or call them. It has been a very smooth process,” she says.

So far the hospital has already seen positive results from the program. “One of the exciting things we’ve found is that the people coming into this want a career. They don’t just want a job. So they are very willing to go above and beyond,” Boppre says. “This raises the bar for everyone.”

When apprentices progress to the on-the-job learning phase of the program, coding supervisors will mentor them. “This is part of their responsibility—to train new staff. So it’s built into their job descriptions, and that’s the expectation,” Boppre says.

She encourages other HIM directors to consider the AHIMA Foundation apprenticeship program as a way of preparing for future staffing needs—and giving back to the industry by offering people their first professional break. “You don’t need to take a lot of students. Even if it’s just one or two, you’re going to be helping secure that future of our organization and profession,” Boppre says. “I think that’s part of our commitment as credentialed professionals. Someone had to give me a chance… and I’m hoping I can do that for professionals who need it.”

Lisa Eramo (leramo@nullhotmail.com) is a freelance writer and editor in Cranston, RI, who specializes in healthcare regulatory topics, health information management, and medical coding.


Article citation:
Eramo, Lisa A. “Building a Talent Pipeline: AHIMA Foundation Apprenticeships Help Connect Prospective HIM Professionals with First-time Jobs” Journal of AHIMA 88, no.5 (May 2017): 20-23.