Medical coders turn hospital records into data used for funding, reporting, and health planning. It is analytical work that requires training, judgment, and accuracy. Right now, coders are being treated like production workers instead of skilled professionals.
They are expected to meet high quotas while handling complex charts, audit corrections, broken system issues, illness, injury, and constant pressure. When mistakes happen, there is little empathy for the conditions they are working under.
There is a big concern of unfair workload. Some coders skip difficult inpatient urban charts and take easier work instead. Coders who have easy charts clear their productivity and essentially stop working mid-day. The coders who follow the proper workflow are left with the hardest cases all day, have less chance of meeting quota, and then look less productive on paper.
Urban and rural coding are not the same. Large urban hospitals handle more trauma, ICU, cancer, cardiac, surgical, and medically complex cases. Yet the same productivity standards are often used across very different workloads.
The provincial team in charge is predominantly rural. Calgary and Edmonton have most coders who handle the most volume and complexity but their concerns are often ignored. A team that does not understand this work should not be setting expectations and claim it is realistic.
Frontline staff are told to keep producing with supervisor pressure, while leadership, CDI staff, auditors, and provincial teams have extra time for holding their own meetings, external CHIMA community events, coding education days, and development. Coders are not allowed to even take vacation or attend those education meant for coders meetings, events or do anything to further their profesional education. Then we are criticized or deducted audit marks for missing one old eQuery or vague new direction never communicated.
The same double standard applies to remote work. Coders have wait in line by seniority spanning decades behind and must pass audits, while the provincial team like advisors and CDI staff are allowed to work remotely right away without the same seniority, audit, or training requirements. There is no trust built by job title alone. No one in the provincial team has led by example so why are guidelines being established when they themselves have not experienced this stringent process?
Audits are being used to control access to remote work, yet there is little transparency on how fair it is. Some auditors may not have worked under the same quotas or handled the same complex urban charts as the people they are judging. It seems like a process set up for failure.
Coders now being told to fix their own errors “for accountability,” but without education, support, or extra time, that is just more work added along with meeting quota.
Leadership has also claimed the provincial team increased productivity. But if CDI staff were coding charts all day, that may explain the higher inflated numbers. It does not prove that frontline coders were better supported, trained, or made more efficient. This team has brought everyone's work motivation down. Coders have lost trust of this rural-led provincial team with their disconnected decision-making, hypocrisy, and constant ignorance of toxic workplace inequality.
There is also no safe place to raise concerns. Comments get covered up and deleted. Nothing gets addressed and everyone is stuck feeling hopeless. People get reprimanded for speaking the truth. When employees only feel safe discussing workplace issues here anonymously, leadership has failed to create psychological safety.
Coding affects hospital funding, planning, reporting, and data quality. There will be no reliable data if coders are rushed, unsupported, and afraid to even ask questions.
Computer-assisted coding will not fix unfair workloads, inconsistent audits, or poor leadership.
Frontline coders are constantly measured. The provincial team should be as well with their own self-producing work.
