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Now is the time to break into coding. Demand for coders is at an undeniable high, and with a variety of new training programs aiming to fill that void, there are more ways than ever to acquire the necessary skills. So making the switch should be easy, right? Not necessarily. While many medical transcriptionists, clerks and others already in the health care field have had no problems making the transition, others have found that it's harder than they thought. Some chose the wrong training programs. Some have all the right training, but can't manage to acquire the necessary experience. Others have trained and gotten hired only to find that coding is simply not for them. ADVANCE spoke to educators, employers and others involved in the field to find out how those interested in breaking into coding can increase their probability of success.
Is Coding for You?
Coding is a dynamic field, full of opportunity. But as with any profession, it's not a perfect fit for everyone. "One thing that I hear from students is that they were not aware of all that's involved in coding within an acute-care facility," noted Jeannie Bostian, CCS, coding manager for Northeast Medical Center in Concord, NC, which has its own in-house training program and is also affiliated with a coding certification program through its College of Health Sciences. "They want to do the job upfront because it looks like a high-paying desk job. When they walk through the shoes of my coding staff, the tune does change and they gain a new respect for the profession."
Effective coders possess a wide knowledge base. Anatomy and physiology, medical terminology, disease processes, documentation requirements, coding classifications and reimbursement systems must all be mastered to do the job properly.
In addition, coders must possess the ability to work independently for long periods of time, but still have the interpersonal communication skills necessary to approach physicians for clarification when necessary.
"Make sure you know your temperament before you contemplate a coding career," cautioned Michelle Wieczorek, director of health information management (HIM) at Saint Vincent Health Systems in Erie, PA, which recently started its own coder-training program. "Coding isn't for everyone and especially those who need a lot of human interaction in the course of their day to get the job done. Coders tend to require less external stimulation, need to be able to focus and concentrate on details for extended periods of time and be able to make independent judgments. Temperament is just as important an attribute to examine in a potential coder as book smarts and tolerance to stress."
The best way to determine whether or not you would be well suited for a career in coding is to do thorough research. Both the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) offer valuable information on all aspects of the coding profession. Even more valuable, however, is first-person feedback. Sit down for a chat either in person or via e-mail with someone currently working as a coder and pick his or her brain. Visit the coding department at a local facility or call a national coding firm with a pre-written list of questions. The more you know about the profession before you join, the more prepared you'll be, both for training and job-hunting.
The Right Education
Which brings us to the next step in the process-selecting the right training program for you. While it might be tempting to select the cheapest, closest or easiest program, your success in coding may very well depend on where and how you get your education. Ideally, your job hunt should start with your search for the right school. Remember, the ultimate goal goes beyond a diploma or certificate. In the end, it's a great job you're after.
There are more options than ever for learning to code, which makes selecting the right method a bit more difficult. A good place to start is deciding which type of program is right for you personally. Most programs fall into three categories: on campus, online or in-house. Each type of program has its own unique advantages and disadvantages.
A coding program at a local college or technical school, for example, can offer enrollees not only an education, but also the chance to get some experience under their belt and a foot in the door. Most offer internships at local hospitals and health clinics, which can help aspiring coders acquire, at the very least, some nice references for their resume or even better-a job after graduation.
At Northwestern Business College, for example, students are required to go through a rigorous externship covering three different learning areas. "It's heavy duty stuff where they really get hands-on experience," explained Nancy Loglisci, dean of the office of career development for the Chicago-based school. And frequently, that experience translates into job offers. "If you go out in the field and are practicing and someone sees the kind of individual you are, they will hire you," Loglisci reported.
Unfortunately, however, on-campus education isn't an option for everyone. Many people do not live within commuting distance or have work schedules compatible with traditional classroom learning. For those people, online programs can offer a valuable alternative. Both AAPC and AHIMA offer educational programs on their Web sites (www.aapcnatl.org and www.ahima.org, respectively). In addition, colleges such as Santa Barbara City College, Alfred State University and others have begun to offer coding and other HIM-related courses over the Internet. The content of these courses is, for the most part, exactly the same as it is in the classroom, and the online format eliminates the commute and offers greater flexibility.
With this flexibility, however, comes great responsibility. Learning online requires a great deal of independence and self-discipline. And although many programs do offer placement assistance, some students may find that without the experience of an externship or internship, getting a first job can be a bit tricky.
Whether you choose to learn on campus or online, be sure that the program you choose is accredited.
For those already employed by a health care organization, the ideal solution is an in-house training program. Like Bostian and Wieczorek, Gloria Litton, RHIT, CCS, director of coding services for the University of Virginia Health System has sought to fill her open coding positions by training people already employed by her organization. "We are teaching people from other areas of the hospital, like health information services, transcription, finance and unit secretaries," she reported. "From our first class, we have several who are taking their certification exams through AHIMA and AAPC. We also have several students who are cross-training in coding in some area of the hospital for full-time employment or to serve in a pool as a PRN coder."
"The advantage of being trained in a hospital setting is that you get a 'feel' for the workings of a hospital, especially the flow of charts through medical records," added Marietta Hataway, who trained at Baylor University Medical Center in Dallas and is currently employed there as a coder. "Another advantage is the in-service lectures given by doctors and other medical personnel, sometimes right in the classroom. I can't imagine feeling as comfortable with coding after just five months of on-the-job experience had I not taken this particular class."
Some facilities, such as Wieczorek's Saint Vincent's Health System, will even pay while you train, which for many potential coders is a huge plus, although others may find the trainee wages too low.
Another blessing/curse of in-house programs is that many require that students agree to work for the organization that trained them for a specified amount of time. (Saint Vincent's, for example, requires a two-year commitment.) While some new coders are thrilled at the prospect of having a job right away, others may chafe at the thought of having to stay in one place for a specified amount of time.
Your First Big Break
Many facilities, however, do not have the time to do any training at all, which can make getting your first coding position more difficult than expected. It's the HIM field's biggest "catch 22": hospitals and companies want experienced coders, but no one can get that experience if they can't get a job.
"We cannot hire new recent graduates because we advertise that we furnish only experienced credentialed coders and we must follow through on that commitment," explained Charlotte Stockton of STAT Solutions Inc. "The hospitals pay exceptionally well for our services and we must furnish coding specialists who are familiar with all hospital systems and are able to go into a hospital and only ask for their policies and procedures. They are not there to be trained by the facility."
STAT Solutions, and other companies like it, require credentials and a minimum of three years experience. Many hospitals are just as discerning when hiring for their permanent staff. Entry into the field is far from impossible, however. It just requires a little pre-planning, some ingenuity, a bit of flexibility and a lot of persistence.
Membership in a professional organization (either AAPC or AHIMA) is a great place to start. Both offer members access to job listings they may not have access to elsewhere. In addition, they offer ample networking opportunities on a local, state and national level. "Networking is extremely important and a very effective way of finding a position," noted Karen Kostick, RHIT, CCS, CCS-P, practice manager, coding products and services for AHIMA.
In addition, Kostick advises new coders not to be intimidated by the requirements listed in most "help wanted" ads. "Even if the ad says two to three years' experience, you can still apply for the position anyway," she said. Or consider getting some experience by volunteering. "Volunteering can open the door to a part-time position and so on," she noted.
If you can't find a position, or even a volunteer gig, in the traditional hospital setting, consider expanding your horizons. "Everyone tends to go to the hospital setting because it is the most traditional," Kostick noted. "But my suggestion is to take a look at other types of settings. Physician offices, home health, long-term care, behavioral health-there are all sorts of places that need coders." Sometimes simply looking through the yellow pages for an alternative setting and sending in a resume can yield that first big break.
Keep in mind, also, that the rules for finding a coding position are the same as for any other job search. Your resume should be properly formatted and free of errors, your interview skills strong and your appearance professional.
Above all, be patient and know that the vast majority of those looking to make the move into coding do so successfully-even if it takes a little time.
Gretchen Berry is a free-lance writer in Phoenixville, PA.
Trouble Breaking Into Coding?
Have you or someone you know had trouble getting that first job in the coding field? We frequently hear from readers about the ominous "Catch-22." No experience, no job. No job, no experience.
Currently on our Web site, our Opinion Poll asks: Despite the coder shortage, have you or someone you know had trouble getting a first job in the coding field? A surprising 78 percent of our readers have said "Yes!"
Join in our brief survey and let us know if you've experienced trouble too. And you can add additional comments to our Bulletin Board titled "Breaking Into Coding." Both the bulletin board and the Opinion Poll can be found at www.health-information.advanceweb.com. <% footer %>
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