What does Coding and Chickens have in common?  Nothing really except for the letter C. 😀  But if you code and have chickens then they go together since coding helps provide food and shelter for the chickens.  Sometimes I have people ask about coding.  What is it? Where to start on that path? How do you get your foot in the door?

Coding is a fast growing line of work in healthcare.  More and more employers are sending their coders home to work remotely because of the EHR (Electronic Health Record) taking over the paper charts.  These are just like paper charts except they can be viewed on the computer or other electronic.

What is coding?

Whenever, wherever a patient goes for healthcare there are codes that are assigned.  The coders look over the documentation of a patient’s visit in the chart/EHR and assign codes for the diagnosis, procedure, services, and equipment that was transcribed for that visit.

Where to start? 

Many employers today require coders to be certified either through AHIMA or AAPC.  I’m certified through AHIMA so I will be referring a lot to to that organization, but AAPC is almost the same.  Each one has their own set of certificates to choose from. Some of the AHIMA certificates are CCA, CCS, RHIT, RHIA, etc.  There are many more certificates but these are the most popular ones that are listed on job applications.  The most desirable certificate is the CCS which has a large portion of its’ exam dedicated to coding documentation and coding guidelines, but there is still other areas that one has to be knowledgeable in (compliance, information technology, legal issues, etc).  An exam test is multiple choice, it can last around 3 hours or more…depending on which test you are sitting for.  The fees for these test are $200 and up.  AHIMA only allows one try.  If you fail, you will have to pay again to retake it.  AAPC allows two tries for their certificate test.

In order to take the test, they usually require taking a certificate program or getting a college degree through an accredited school or having done coding for an employer for so many years.  It depends on what you are interested in and what path you are going for.  I started off enrolled in a coding certificate program, then later ended up taking other classes to gain the Health Information Associates.

Many people usually either go for the college degree or certificate program.  If this is where you are right now, then please go to AHIMA or AAPC website and search their list of accredited schools.  With AHIMA you can search schools that are either all online or where you can go on campus.  My advice with schools is to do your research on their coding certificate program and the degree.  In the past, I had to look at several different online schools because even though you apply in the summer hoping to take fall classes, you would have to wait until spring of the next year because they only have certain classes at certain times.  It can be very frustrating but as long as you do your research on the programs they offer and look at their suggestions on what classes to take for what semester you shouldn’t have any surprises.

How to get your foot in the door?  

I want to write that getting a job in coding is easy after you get the certificate.  It’s not, but it can be done.  A lot of employers want the candidates to have one to two years in coding along with the certificate.  What new graduate has two, let alone one year of coding under their belt?  It took me a year and a half to land a job in coding after getting the certificate.  Before getting certified, I had a lot of years in healthcare behind me so I was already familiar with a lot of terminology and had hands on experience with EHR.  I even had real, on the job experience with the encoder (a software on the computer used to assign codes) because I had approached the coding manager and asked if I could sit with her some time to see what the coders do.  By asking, I was able to gain hands on experience with the encoder, assign codes to clinic notes.  At that job I didn’t transition to the coding position because I moved to the country which led me get another job closer to home.  However, if you are in the healthcare setting already with access to the coding department then go ask like I did.  Some employers will hire you into the coding position if you are going to school and promise to take the certificate exam by a certain date.   If you don’t work in healthcare then I would suggest applying for any jobs in the Health Information Department.

Make sure you update your resume with your certificate initials behind your name and write out the full name of that certificate.  Also put what group you have your certificate through.  Example:

Pam Chick, CCA

123 Grape Lane

Nowhere, VA 00000

 

Objective: Looking to build skills while helping the organization reach its goals

Qualifications: Certified Coding Associate

AHIMA Member

Knowledge in assigning ICD 10 CM and PCS and CPT codes

When I was looking for a job in coding, I searched coding resumes.  I read that HR will sometimes screen for the the certificate initials or even the whole abbreviation of the certificate.  By doing this it will cover you when they are searching for keywords in your resume or application.  When I did speak with HR while setting up an interview for a job, the lady didn’t know what the certificate meant.  The more information you put on your resume and application the better!

Remember, when you go in for a job interview they will most likely make you take a coding assessment.  I had one interview where I was asked to take it right after the interview.  Another job interview (actually the job I work at now) asked me to come back on a different day.  When I went in for the assessment the manager asked if I wanted the books or the encoder, I said both.

If you are applying and never hear anything back, then apply for all coder 1 and outpatient positions with that company.  I applied for all coding jobs that were coding specialist 1 and outpatient with one company until I received a message stating I had exceeded the amount of applications I could turn in.  I did get a call from HR about a week later and went in for an interview but didn’t get the job.  That was okay because I ended up getting hired else where about a week after that.

As I had mentioned before, apply for other HIM jobs.  If you are hired for an HIM job you can always show how hard you work, your reliability, how well you get along with others, etc.  By them seeing you, interacting with you, that will make them more willing to transfer you over to the coding position.  They will know you are a good employee and would rather transfer over one of their own then to hire someone brand new into the position.  However, beware of the supervisors and managers that promise to put you into a coding position but after months of waiting, nothing happens!  If you are in this position, you may have to look at other healthcare facilities or just tell them straight up it is taking too long for them to move you to the coding position and you will be applying else where for the position.  I would not keep the promise unless it is written and signed with a start date for the coding job.

 

 

How I got my coding job:

While going to school for the coding certificate program and HIM associates degree, I was working in Release of Information in the HIM department.  I asked the coding manager if I could sit with her to see what the other coders do.  This opened a path for me to gain experience with the encoder and practice on assigning codes with accounts.  I met up with the coding manager once a week and soon was granted by my ROI manager a couple of hours a week to work on coding accounts and then meeting up with the manager to go over with the codes I had assigned.  I’m pretty sure I would have eventually transferred over, but I ended up moving 2 1/2 hours away.  This ended up in me applying for any job in healthcare that would be closer to my house..which would be a 1 1/2 hour drive.  I really wanted to stay in the HIM department but beggars can’t be choosers, right?  I took on a receptionist job.  Even this job was hard for me to land because people did not want to hire me since I lived 1 1/2 hours away.  I had one interview where the lady kept making comments on the drive.  I told her it really wasn’t that bad and that I used to just sit in traffic for an hour… at least now I was driving and would listen to my audiobooks on CD.

I ended up working as a receptionist for a clinic at a well known healthcare facility.  I was super excited since this healthcare facility was one of the biggest in the eastern side of VA.  They had even bought out the small town healthcare facility that was 30 minutes from my house!  I kept my eye on the facility website, waiting for them to finish merging, and post jobs.  It took a while before any jobs were posted.  In the mean time, while I was waiting, I graduated with my associates in HIM.  Shortly after that I took the CCA exam, gaining my certificate.  When I got my certificate I told my co-workers at work.  Everyone was happy for me except for the supervisor who just said oh okay.  That should have been a warning right there.  She didn’t say good job or congratulations…nothing.

Now I had my CCA certificate but still working a receptionist job.  As I continued to work, I kept applying for remote and onsite coding jobs.  I was willing to still drive 1 1/2 hour away as long as I was coding but I also decided that I would be happy to drive that amount of time if it for a non-coding job in Health Information.  Being a receptionist was okay, I had worked as one for two years at a healthcare in the past.  This job pretty much threw me into the position.  The supervisor sat with me on the first day for an hour and then I was on my own.  I thanked God back then for the nurses because they were my co-workers and helped me so much and doctors were patient.  At that job I was checking in patients for 2 doctors, sometimes 3 and the phone would ring all day long. I would have to call and confirm appointments the day before, send messages back to the nurses as appropriate, page the doctor that was on-call for the hospital, etc. and I was by myself for the longest time.  They finally hired someone else to work with me when we had three doctors full time but it was still a lot of work and believe me pateints weren’t happy and took their frustrations out on the receptionist.  There were other things going on as well that weren’t right with the management but I will drop it.

After getting my certificate, I was finally getting to take assessments for online jobs and was being considered for onsite coding positions…before I would be denied right off the bat.  The certificate is the golden ticket…think about Charlie finding the golden ticket in the movie Charlie and the Chocolate Factory.  That is how important the certificate is.

A month after getting my certificate, I received a call for a data entry specialist job at (lets call it) ABC Healthcare.  The job was 1 1/2 hour away but it was in the Health Information Department so gladly I went.  I ended up being interviewed for this position as well as an HIM tech.  Fine by me!  I wanted back into the Health Information Department.  They did ask me about my coding certificate while I was there.  Long story short, I didn’t get either job.  I don’t think they were eager to hire someone that lived 1 1/2 hours away.

A couple of more months passed by, and finally the place where I worked at had a receptionist position open at the facility that was 30 minutes from my house.  I put in an internal application.  Two weeks later I went in for an interview.  All seemed well.  They had another person to interview, then would get back to me to let me know if I had a job or not.  About a week after that my manager and supervisor approached me with an offer to place me into the coding position at one of other locations that was about an hour away from my house.  Awesome!  I thought this was it.  Finally, I was going to be a coder.  The only condition of this was for me to promise not to put in anymore transfers.  I was fine with that because coding is what I wanted to do.  Looking back, I should have demanded this on paper and when I would start.  Days, weeks, and months rolled by.  Anytime I approached them in regards to the position they wouldn’t give me any information.  They were dangling a carrot, which had me fall foolishly into their trap.  Not too much longer after this I put my 2 weeks in and quit.  I had no job lined up, some money in savings.

This was a scary time.  What would I tell a future employer?  I felt shameful that I had quit with no real plan, no job.  I have never done that in my life.  I tried not to dote on it too much.  I continued to look for coding jobs only this time, even attending the AHIMA job fair online which a lot of those employers want you to have the two years experience.  I filled my time with picking up the boys from school, cleaning house, playing with chickens, applying for several jobs a day, taking coding assessments online, studying for the RHIT exam, etc.  Six months after my interview with ABC healthcare, I saw that they had a remote coding position for coding specialist 1.  I applied for it.  A week later I got the phone call to come in for an interview.  I decided when they asked why I left the job my response would be I was promised a coding position but it fell through, I decided to quit to focus on studying for the RHIT.  In addition to that I thought of some other questions they may ask (which they did). Is your certificate for ICD 9 or 10?  I had to turn in CEUs to have my certificate upgraded to ICD 10 thank goodness I did that!  What coding experience do you have?  I brought up the patient accounts me and the old coding manager had worked together at my previous job.  When I went in for the interview,  it surprised me that some of the ladies had remembered me.  At the end of the interview I told them that I believe I would be a great fit and really wanted the job.  I don’t know if this helped or not.  When I had left, I felt like I had the job, they just didn’t say you can start on such and such day.  Three weeks rolled by, I never heard back.  I even called, left a message for the coding manager and never got a call back.  I went ahead to another interview and didn’t like these ladies as much as the others, but I still hoped I would land a coding job.

Finally, I got a phone call.  It was from ABC healthcare.  I was offered the remote coding position and had a start date.  When I went into orientation I had to write on my packet that I was a remote coder specialist 1 and still couldn’t believe I was a coder. Finally.  I get butterflies in my stomach even now just thinking about being a remote coder, what I had to go through to get to where I’m at.

I typed all this out for you to read in hopes you can learn from what I went through.  When you want something, sometimes you have to work extra hard and deal with people that will try to drag you down.  Keep applying for the jobs and stay positive.  Sometimes things will not work out the way you think it will…take me for an example!  If I had never gone in for that first interview with ABC healthcare,  they may have never hired me when I had gone in for the coding interview.  You just don’t know unless you try!