Thirty-four percent of full-time coders reported learning on the job. Farrell indicated this might be due to a lack of publicity for the HIM profession. "There just isn't a huge movement attracting people to this profession, where they're going straight into a 2- or 4-year college and then starting [their career]," Farrell said. "I still think there has to be more publicity around what a valuable profession this is and what a rewarding career it can be for people."

Another interesting note in the coding realm was at-home coders (12 percent) actually rake in more money than their in-house colleagues. At-home coders reported bringing in an average of $45,400 annually, while the 60 percent of coders who are in-house garnered an average of $43,000. Farrell saw a simple explanation for this. "They're sending their best people home," Farrell explained. Facilities are requiring lots of qualifications from coders who wish to telecommute, and certain milestones must be reached in many cases for a coder to be able to work from home.

Overall, Farrell attributed the 21 percent increase in coder salaries from 2007 to 2008 to two things: high demand for experienced professionals, and an increased focus on the revenue cycle in a hospital. "I think those are the two critical factors, which is exciting," Farrell said.

 HIM Directors Get a Raise

In 2007, HIM directors reported making $68,500. This year, that salary rose by 7 percent, up to an average of $73,400.  As far as credentials go, HIM directors holding a registered health information administrator (RHIA) (43 percent) garnered an average of $83,300. Last year, RHIAs brought home an average of $59,100, and this year, full-time RHIAs raked in an average of $70,500. Fourteen percent of HIM directors held no credential, and reported an average annual salary of $63,200. On the education front, 93 percent attended college, with 87 percent holding at least an associate degree.

The stats on one question new to the survey this year support the spike in HIM directors' pay--85 percent reported getting a raise, while 13 percent saw pay stagnate and 2 percent actually reported a decrease in pay. Farrell said she was surprised to see people with salaries staying the same or dropping. Many facilities are adjusting to the new economic climate, Farrell said, and these numbers represent the financial crunch in the health care industry. "I just think it's tight times for everybody," Farrell explained. "That's in the news every day."

 Cancer Registrars See Increase

This year, 310 cancer registrars and cancer registry managers completed the ADVANCE Salary Survey, and they saw a bigger pay raise than most other HIM professionals we polled. With full- and part-time registrar average salaries combined, to stay consistent with last year's results, cancer/tumor registrars saw a jump from $36,400 to $39,800--an increase of more than 9 percent. Full-timers brought in $41,600. Toni Hare, RHIT, CTR, vice president, oncology data services, and Jordana Revella, director of marketing, CHAMPS, a Cleveland, OH-based firm that provides cancer registry consulting, agreed that the ADVANCE numbers fall in line with what they've been seeing in the industry.

Hare expressed surprise that 86 percent of registrars hold a certified tumor registrar (CTR) credential. "That is a standard from the Commission on Cancer, so really, I thought it was going to be a little bit higher," Hare said. "I was surprised to see it that low."

She attributed the number to people who haven't taken the test yet because they aren't eligible, which Hare also said would account for the fact that non-credentialed registrars earned approximately $10,500 less per year than their credentialed counterparts. Hare said she thought the spread between credentialed and non-credentialed registrars would be wider, but noted those without a credential may have a college degree and might just be building up experience to sit for the CTR exam, which would account for the slightly higher average salary.

Hare also said it was interesting to see how many registrars reported having a high school diploma or a GED (9 percent) rather than college experience or degrees. In the future, she predicted that the number of registrars who possess college degrees will increase as the Commission on Cancer standards continue to focus on quality and National Cancer Registrars Association eligibility requirements for the CTR exam have changed. She does expect that the number of registrars with only on-the-job training (57 percent) will decrease over time, as requirements for the CTR are changed. In 2010 one path to the CTR is to have an associate degree and 160 hours of experience in a CTR-staffed registry. The degree, however, doesn't have to be in cancer registry, Hare noted.

Overall, Hare and Revella were pleased the salaries for cancer registrars rose according to our survey. "I'm glad the demand for education and CTR certification is driving this," Hare said.