HIM 520 Module 2 Human Resources Short Paper Example

Why Coders Leave and What Makes Them Stay: Human Resource Management in Sycamore Bend's Merged HIM Department

[Student Name]

Southern New Hampshire University

HIM 520: Leading as a HIM Professional

Module Two Short Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Why Coders Leave and What Makes Them Stay: Human Resource Management in Sycamore Bend's Merged HIM Department

Sycamore Bend Health's merged health information department lost 14 of its 67 coders last year, a turnover rate of 21%. Each departure costs recruiting time, months of reduced productivity while a new coder learns the system and pressure on those who remain. The merger made the problem worse by putting coders with different pay, titles and expectations on the same team. This paper uses research on turnover and work design to explain why coders are leaving and proposes human resource practices to recruit and keep them.

Why Employees Leave

Turnover research has moved beyond simple job satisfaction. Hom et al. (2017), reviewing a century of turnover research, describe how departures reflect not only dissatisfaction and better offers but also how embedded people are in their jobs and communities: their ties to colleagues, how well they fit the organization and what departure would cost them. Remote workers can be less embedded simply because they have fewer daily connections. Work design matters too. Pooling many work design studies, Humphrey et al. (2007) showed that job characteristics such as autonomy, task variety, feedback from the work itself and social support were related to satisfaction, commitment and performance, which suggests that how coding work is organized affects whether coders stay.

What the Exit Interviews Show

Exit interviews with 11 of the 14 departing coders revealed three themes. Eight mentioned pay, especially coders from the acquired hospital who learned that colleagues at the flagship earned more for the same work. Seven described feeling disconnected after moving to remote work, with little contact beyond productivity reports. Six said they saw no path forward, since the only step up was supervisor, and supervisor roles rarely opened. Only two cited workload. These themes match the research: pay inequity undermines fairness, isolation weakens embeddedness and a flat structure offers no reason to stay.

Harmonizing Pay Fairly

The merger left three pay scales for coders doing the same work, with gaps of up to 11% at the same credential and experience. A fair harmonization plan will place every coder on a single scale based on credential, years of coding experience and demonstrated accuracy, and raise those below their new step immediately rather than waiting for annual reviews. No one will be cut, and coders above the new scale will be held at their current rate until the scale catches up. Human resources will also compare the new scale with regional market data, since several departures went to competitors offering remote roles.

Job Descriptions and Competency-Based Hiring

The three hospitals used different titles for similar work. The department will adopt one set of job descriptions, Coder I, Coder II and Coder III, each defining duties, required credentials, accuracy and productivity expectations and the work settings allowed. Hiring will rely on demonstrated competency: every candidate will complete a short coding assessment using deidentified records, scored by two senior coders, and a panel interview built on one fixed list of scenario questions scored against a shared guide. These practices make decisions fairer and help new coders start in roles that fit their skills.

Recruiting in a Tight Market

Filling the open positions requires recruiting beyond local newspapers and job boards. Sycamore Bend will partner with two regional community colleges that run health information technology programs, offering paid practicum placements that often lead to offers. Because remote work widens the pool, postings will state that experienced coders may work from anywhere in the states where the system is registered to employ staff, with pay tied to the single scale rather than to location. The department will also offer a referral bonus to current coders, since employees referred by colleagues tend to start with stronger connections to the team.

Wage and Hour Rules

Most coders are hourly, nonexempt employees under federal wage and hour law, so they must be paid for all hours worked, including overtime at time and a half beyond 40 hours in a week. Remote work makes this easy to get wrong: a coder who finishes charts after logging off, or answers messages in the evening, may be owed pay for that time. The department will require coders to record all time worked, prohibit unapproved work outside scheduled hours and monitor timekeeping for patterns that suggest off-the-clock work.

A Career Ladder

To give coders a reason to stay, the department will create a ladder that rewards growing skill rather than only promotion to management. Coder II requires two years of experience and 95% accuracy; Coder III requires an additional specialty, such as inpatient or surgical coding, and participation in auditing or teaching new coders. Each level carries a pay increase. The department will also create two coding educator and auditor roles, which add task variety and feedback, the job characteristics Humphrey and colleagues linked to satisfaction.

Keeping a Remote Team Connected

Remote work is not the problem to solve; it is a benefit to manage well. The randomized trial reported by Bloom et al. (2015) found home-based staff both more productive and far less likely to quit, yet some volunteered to go back to the office because they missed their coworkers, precisely the loneliness Sycamore Bend's exit interviews describe. The department will hold weekly team huddles by video, assign each new coder a mentor, schedule an in-person gathering twice a year and ensure supervisors meet one-on-one with each coder at least monthly. These practices build the connections that research on embeddedness suggests keep people in place.

Measuring Results

The plan will be judged by coder turnover, with a target below 12% within eighteen months, time to fill open positions, the share of coders on the career ladder above Coder I and responses to engagement survey items on fairness and connection. Exit interviews will continue, since they reveal whether the reasons for leaving change.

Conclusion

Coders are leaving Sycamore Bend because pay feels unfair after the merger, remote work has become isolating and the job offers no path forward. Harmonizing pay, hiring and describing jobs consistently, following wage and hour rules carefully, creating a career ladder and building connection into remote work address each reason. These actions will become part of the leadership assessment in Milestone One.

References

Bloom, N., Liang, J., Roberts, J., & Ying, Z. J. (2015). Does working from home work? Evidence from a Chinese experiment. Quarterly Journal of Economics, 130(1), 165-218. https://doi.org/10.1093/qje/qju032

Hom, P. W., Lee, T. W., Shaw, J. D., & Hausknecht, J. P. (2017). One hundred years of employee turnover theory and research. Journal of Applied Psychology, 102(3), 530-545. https://doi.org/10.1037/apl0000103

Humphrey, S. E., Nahrgang, J. D., & Morgeson, F. P. (2007). Integrating motivational, social, and contextual work design features: A meta-analytic summary and theoretical extension of the work design literature. Journal of Applied Psychology, 92(5), 1332-1356. https://doi.org/10.1037/0021-9010.92.5.1332