Two oversized flat-panel computer displays stand waiting for Pat Pilant. One feeds her an avalanche of hospital patient charts: hundreds of pages choked with obscure medical jargon, ambiguous abbreviations -- pure gibberish to the uninitiated.
But for Pilant, a medical coding specialist, "it's like reading a mystery novel." Each case begins with a stricken patient. Doctors and nurses puzzle over symptoms, hazard a diagnosis and attempt treatments. Are they right? Will the treatment work?
Pilant pours over each chart, some running to 300 pages or more. Entering a mental zone of concentration, she resolves conflicts, fills in gaps, and distills the jumble of information into a neat set of codes. The codes specify the charges billed to insurers and government health plans for each hospital stay. Increasingly, researchers are using coded hospital data for such uses as tracking disease trends and comparing the quality of competing hospitals.
But finding people who are able -- and willing -- to do the coding is not so easy. Coders are in such high demand that medical centers across the U.S. routinely have to call in reinforcements. Freelance coders jet from hospital to hospital to rescue backlogged billing departments. They earn as much as $40 an hour, with travel expenses covered.
If you are an accurate coder, "consultant companies are really begging for you," says Pilant, who works full time for Providence Health System from a home office in West Linn. About three-quarters of Providence's coders work from home, putting in an eight-hour shift on a flexible schedule.
After 18 years in the profession, Pilant claims to have never been bored: "It's always exciting. There's always something new to learn."
The career blossomed for her after staying home to raise two children in Bend. Medicine and the workings of the human body fascinated her. But squeamishness ruled out working directly with the sick and wounded. She completed a two-year community college program and went to work for a local hospital. It can take up to three years of on-the-job training to become proficient, she says.
The work gets more complicated every day, with the expanding reach of tests and treatments. Each new procedure tends to generate a multiplying family of codes.
"You will never master it," she says.
JOE ROJAS-BURKE
