# Things Need to Change



## terriwarren

Things need to change in the professional world. I graduated from Sanford-Brown Institute's Medical Billing and Coding program in 2009. On the second try, I got my CPC-A in 2010. Unfortunately, Sanford-Brown didn't have an externship program for MBC, so I was not able to get any actual experience. That is the ten-foot thick concrete wall I have been hitting. I have applied for a variety of positions, not just coding, just to get my "foot in the door," and hear the same thing over and over: "Minimum two years' experience required." This has to change if new coders are to actually GET that experience. I have even seen positions that are open for long periods of time, because they are turning down new coders, waiting for experienced coders. Wouldn't that time have been better spent training a new coder for the position? If that were done, then the organization would have known they had someone who knew how to do the position to their satisfaction. 

New coders deserve a chance that they are not getting. Currently, I am volunteering at Laurel Regional Hospital. It is not in any area that will help my search, but I am working with the Volunteer Coordinator to move to an area that will. So I am not giving up, but it has been an uphill battle trying to find a position to get my career started. A battle that is not over yet, and has no end in sight. There are very few positions I can do in the meantime, because I am disabled. 

It seems a shame that I struggled to go to school while living in a homeless shelter, graduated with a 3.88 GPA, only to not be able to find a position now that I am graduated and certified. I really need someone to read this post and respond. I need to know what to do now. I have been struggling on my own since I graduated, and even before. Please help.


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## PattiL

Have you tried community health centers or FQHC's? They are sometimes (in my experience- I worked for one) willing to take on newly graduated coders and train them. 
Good luck, I hope you find something soon. You are right, it's not fair and it needs to change.


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## bbrucew@bellsouth.net

I agree. I was in the same position at my school where there was not an externship for that program. I think the first approach should be that the AAPC or AHIMA needs to push for schools to create externships for the Medical Billing and Coding program. I think it would also be nice if the local chapters could reach out to local physician offices when newly graduated students that have already passed the CPC exam can get interviews etc.


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## terriwarren

Thank you for the advice. I have been applying to the Patient First clinic in my area, without success. I am looking for other clincs, and continue to try to find something at the hospital where I am already volunteering. Like I said, I'm not giving up.


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## pearlgirl54

I agree with Terri...schools are churning out Coders/Billers at an alarming rate in that they have no where to go! Graduate, there ya go have a nice life.  There is an abundance of jobs but as terriwarren points out there is nothing to bridge the gap.   the AAPC also stresses the importance of taking the $300 CPC test....but even passing that doesn't help. I could have used that $300 to pay bills! doctors become interns, even nurses have student nurse status.  but what do coders have. If these other professionals want to get paid for services rendered they need the coders. and there needs to be MORE externships, internships, apprenticeships, whatever you want to call them....if the new coders can't get to the jobs, what is the point??? see you in the unemployment line!


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## twizzle

pearlgirl54 said:


> I agree with Terri...schools are churning out Coders/Billers at an alarming rate in that they have no where to go! Graduate, there ya go have a nice life.  There is an abundance of jobs but as terriwarren points out there is nothing to bridge the gap.   the AAPC also stresses the importance of taking the $300 CPC test....but even passing that doesn't help. I could have used that $300 to pay bills! doctors become interns, even nurses have student nurse status.  but what do coders have. If these other professionals want to get paid for services rendered they need the coders. and there needs to be MORE externships, internships, apprenticeships, whatever you want to call them....if the new coders can't get to the jobs, what is the point??? see you in the unemployment line!



My opinion is that AAPC needs to raise the passing score for their CPC, CPC-H exams. There are so many passing the exams each month that there is absolutely no chance of the majority gaining employment on the basis of holding a certification, particularly if they have little or no experience. Make it a little more "exclusive" for want of a better word rather than making the standards too low for it to be important/relevant. I also agree that coding/billing schools promise the world but fail to deliver on their promise. Perhaps their claims should be better regulated (by AAPC for example) and more accurate. We can all be taken in by the promises of "earn up to $60000 per year and work from home with completion of a medical coding course". I know I was. I've been coding for 4 years and am nowhere near that salary (although I do work for a particularly mean and merciless company). $30000, if you're lucky, is an optimistic estimate depending on your location.


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## terriwarren

wassock said:


> My opinion is that AAPC needs to raise the passing score for their CPC, CPC-H exams. There are so many passing the exams each month that there is absolutely no chance of the majority gaining employment on the basis of holding a certification, particularly if they have little or no experience. Make it a little more "exclusive" for want of a better word rather than making the standards too low for it to be important/relevant. I also agree that coding/billing schools promise the world but fail to deliver on their promise. Perhaps their claims should be better regulated (by AAPC for example) and more accurate. We can all be taken in by the promises of "earn up to $60000 per year and work from home with completion of a medical coding course". I know I was. I've been coding for 4 years and am nowhere near that salary (although I do work for a particularly mean and merciless company). $30000, if you're lucky, is an optimistic estimate depending on your location.


Raising the CPC exam standards won't do any good. Employers don't look at the score, they look at the A after the CPC. All they see is someone with no experience. Even if you got a perfect score, that doesn't equal experience, and that is the key word in every single ad for a coder position. I have even seen Coder 1 positions advertised with experience required. Isn't Coder 1 supposed to be for new coders? By volunteering, I am trying to effectively create my own externship, but it still is not enough. It is all well and good for people to tell me to not give up, but most telling me that already have their jobs. I'm still fighting for mine.


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## twizzle

I know employers don't look at the score. My point is that too many are becoming certified and chasing too few jobs which lowers the standard. Raise the bar and make the test tougher. From what I have seen, there are a lot out there who are certified and are completely clueless. My company is working on a huge amount of denials because 'clueless' CPC's elsewhere have made a huge mess of simple coding.


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## mitchellde

I do not thing the exam is the issue nor is the certification, I think it is the quality of the worker.  The employer is wanting to hire a proven worker someone with experience that can get the job done.  And who can blame them, time is money afterall.  I think the problem is the application process, too many times when I have looked through applications I see individuals that feel entitled to have the job, just from the way the cover letter is worded, the resume is arranged.  I am suppose to hire them because they are entitled to this job.  I turn that down.  I also see ones that beg and plead, I turn those down.  I am looking for someone to benefit me, I am not there to benefit you.. You see how they think?  SO I look for a resume and a cover letter where this person is telling me how they are going to be asset for me.  As an applicant I write my cover letter and resume to reflect how I will be an asset for the company.  I even tell them this in the interview, I let them know I am there to assist them.  I have never been turned down even when I had little to no experience, nor have I ever turned an applicant away that can be that bold and aggressive.


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## MnTwins29

Amen, Debra!   A job seeker has to advertise how they can benefit the employer, not the other way around.   Couldn't have said it better.


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## terriwarren

mitchellde said:


> I do not thing the exam is the issue nor is the certification, I think it is the quality of the worker.  The employer is wanting to hire a proven worker someone with experience that can get the job done.  And who can blame them, time is money afterall.  I think the problem is the application process, too many times when I have looked through applications I see individuals that feel entitled to have the job, just from the way the cover letter is worded, the resume is arranged.  I am suppose to hire them because they are entitled to this job.  I turn that down.  I also see ones that beg and plead, I turn those down.  I am looking for someone to benefit me, I am not there to benefit you.. You see how they think?  SO I look for a resume and a cover letter where this person is telling me how they are going to be asset for me.  As an applicant I write my cover letter and resume to reflect how I will be an asset for the company.  I even tell them this in the interview, I let them know I am there to assist them.  I have never been turned down even when I had little to no experience, nor have I ever turned an applicant away that can be that bold and aggressive.


As a job seeker, I actually take exception to this response. I think many people wind up sounding like they are pleading for a job because doing it your way hasn't worked. After all, how do you know the quality of the worker if you haven't given them a chance? How can they say how they will benefit the company with their experience when they are just starting out and DON"T HAVE ANY? EVERY single one of those "experienced" people you are so proud of got their experience because someone was willing to give them a chance. You and employers like you are creating the concrete wall that is preventing new coders from becoming the "proven" coders your prize so highly. You were new once. What if no one ever gave you a chance? Would you still be the employer that is now so quick to turn down new coders? My resume and cover letter, which are tailored for each position I am applying for, highlight the skills the employer is looking for, describe the duties to prove that I understand them, and I do tell them how I can benefit the company. NONE of that matters if I don't have this magical "minimum 2 years' experience" that EACH AND EVERY JOB requires.


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## dclark7

I take excepetion to many of these posts.  Many (not all) of us "experienced coders" were working before coding became "the hottest new job"  and many of us had experience before we ever became certified.  It is not our fault that somehow people "discovered" coding and schools started turning out more coders than there were jobs for.  In addition, prior to AAPC adding the "A" status we were *REQUIRED* to have two years of experience before we could even sit for the exam.  AAPC did not do anyone, employers, apprentices or experienced coders any favors by adding the designation and not requiring experience before testing.

Add to that the fact that the economy took a dive, many private practices are being bought out by hospital groups, the government is breathing down every providers neck with fraud and abuse, they are requiring EMRS, and alot of older doctors have decided to retire rather than deal with all of this.  What do you get?  Fewer jobs, too many job seekers and providers who want experience so they don't end up on the OIG's hit list.  When my sister graduated from college with a degree in accounting that was the hot job and she couldn't find a permanent job for two or three years.  It was the same thing new coders are complaining about, couldn't get a job without experience, but couldn't get experience without a job.  She worked as a temp until one of the companies she was temping at hired her full time.  I remember reading an article in a local paper about six months ago that newly graduated law students couldn't find jobs because law firms weren't hiring.  You know the economy's bad when lawyers don't have any work. 

The economy goes in cycles and things eventually even out.  Does that help new coders now?  No, but everything comes full circle and if you don't give up you'll eventually accomplish your goal.  Meanwhile stop the blame game and the whining, start networking, it may take awhile but networking eventally pays off.  Someone may know of a job and think of you.  That's how I found my present job, a fellow coder interviewed for it, didn't think it was the job for her but thought I would be a good fit.  It's worked out great, but if I didn't have a network that I had built up over the years I would never have known about it.


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## mitchellde

terriwarren said:


> As a job seeker, I actually take exception to this response. I think many people wind up sounding like they are pleading for a job because doing it your way hasn't worked. After all, how do you know the quality of the worker if you haven't given them a chance? How can they say how they will benefit the company with their experience when they are just starting out and DON"T HAVE ANY? EVERY single one of those "experienced" people you are so proud of got their experience because someone was willing to give them a chance. You and employers like you are creating the concrete wall that is preventing new coders from becoming the "proven" coders your prize so highly. You were new once. What if no one ever gave you a chance? Would you still be the employer that is now so quick to turn down new coders? My resume and cover letter, which are tailored for each position I am applying for, highlight the skills the employer is looking for, describe the duties to prove that I understand them, and I do tell them how I can benefit the company. NONE of that matters if I don't have this magical "minimum 2 years' experience" that EACH AND EVERY JOB requires.


You have mis interpreted, I did not say to tell the employer how your experience can benefit them, I said how can YOU benefit them.  Think about this hard.  It can be little things like how many sick days did you use in your last job.  How do you expect to improve the overall quality.  it is the little things.  I always ask my prospective employees about the sick day usage.  I examine their body language as they reply.  Also be careful about tailoring your resume and cover letter for each position, because the employer knows you did that, and that is not always positive.  I have not created any wall for prospective employees, I and many like me are looking at the whole package and honestly would rather do without than hire someone and is below our expectations.  I am sorry but I put this in here to give you the other perspective.  I hope this can help you in your attempt to find the position you desire.


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## Pam Brooks

terriwarren said:


> You and employers like you are creating the concrete wall that is preventing new coders from becoming the "proven" coders your prize so highly. You were new once. What if no one ever gave you a chance? Would you still be the employer that is now so quick to turn down new coders?


 
How about a discussion from the other side of the fence? I regularly hire brand new coders, and have a part-time position open now. 

It's still open. Here's why.

30 people applied. Only 6 were certified coders, and they were CPC-As, which is what I'm looking for and the job requires. 

One resume had three misspellings. I threw that one out. 

Three of them live over an hour away. That's too far for a per-deim position, with no guaranteed hours, on-call and no benefits. This is New Hampshire, and travel is a big problem with snow, ice and sleet 6 months out of the year (Nov-March). I'll call them, but I really prefer to hire staff that live locally. 

One applicant has applied before. The interview did not go well. I am still on the fence about a callback.

That leaves one applicant, who lives 45 minutes away. I haven't called them yet to see if they'll even take a part time job. Most won't. Over the last year, about 50% of applicants turn down my entry-level part-time positions because they need a 'real job'. 

I am participating in a job fair next month, and pray I will get some local applicants I can actually consider. There are some good employees out there, with great job experience that is totally unrelated to coding. But I get a lot of applicants who passed their CPC-A but just would not be a good fit. I'll say it again--sometimes it's personal. 

So from my perspective, there aren't enough qualified, bright, appropriate and willing entry-level coders in my area who want to take a chance on a part-time, low pay, no benefits job even in an economy where you're lucky to even have a job in this field. But if you do take a chance and work with me and my fabulous team, you'll be working with some of the best coders I've ever had the opportunity to work with, and you'll learn more than you ever realized you didn't know. Unfortunately, everyone wants 40 hours a week, full benefits and $20.00 an hour. You'll earn that (and then some) eventually, but not right away.  

By the way, I started out 22 years ago, answering phones in a mental health agency two days a week for $7.00 an hour. It sucked, but I held on and moved my way up. Without a doubt, I have paid my dues, and so has every single hiring manager on this board. You have unwittingly offended each of us who try to assist new coders with advice (and even job opportunities). Remember, attitude is everything.


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## terriwarren

Pam Brooks said:


> How about a discussion from the other side of the fence? I regularly hire brand new coders, and have a part-time position open now.
> 
> It's still open. Here's why.
> 
> 30 people applied. Only 6 were certified coders, and they were CPC-As, which is what I'm looking for and the job requires.
> 
> One resume had three misspellings. I threw that one out.
> 
> Three of them live over an hour away. That's too far for a per-deim position, with no guaranteed hours, on-call and no benefits. This is New Hampshire, and travel is a big problem with snow, ice and sleet 6 months out of the year (Nov-March). I'll call them, but I really prefer to hire staff that live locally.
> 
> One applicant has applied before. The interview did not go well. I am still on the fence about a callback.
> 
> That leaves one applicant, who lives 45 minutes away. I haven't called them yet to see if they'll even take a part time job. Most won't. Over the last year, about 50% of applicants turn down my entry-level part-time positions because they need a 'real job'.
> 
> I am participating in a job fair next month, and pray I will get some local applicants I can actually consider. There are some good employees out there, with great job experience that is totally unrelated to coding. But I get a lot of applicants who passed their CPC-A but just would not be a good fit. I'll say it again--sometimes it's personal.
> 
> So from my perspective, there aren't enough qualified, bright, appropriate and willing entry-level coders in my area who want to take a chance on a part-time, low pay, no benefits job even in an economy where you're lucky to even have a job in this field. But if you do take a chance and work with me and my fabulous team, you'll be working with some of the best coders I've ever had the opportunity to work with, and you'll learn more than you ever realized you didn't know. Unfortunately, everyone wants 40 hours a week, full benefits and $20.00 an hour. You'll earn that (and then some) eventually, but not right away.
> 
> By the way, I started out 22 years ago, answering phones in a mental health agency two days a week for $7.00 an hour. It sucked, but I held on and moved my way up. Without a doubt, I have paid my dues, and so has every single hiring manager on this board. You have unwittingly offended each of us who try to assist new coders with advice (and even job opportunities). Remember, attitude is everything.


I would actually like to thank everyone for their input. As I stated, there is no way I am giving up the search. It has just been very difficult. I am just as serious as anyone else about coding, and am afraid that the longer it takes to find a job, the more I will start to forget what I learned. It has been hard trying to keep up with the coding changes. Like I said in the original post, I am volunteering at a hospital and working to get in either the HIM office or some other area that will help me get experience. For what it's worth, I AM willing to take a part-time, low pay, no benefits position. I just haven't been given the opportunity. But I am open to more suggestions. Thanks for the attitude reminder.


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## artes_athamas

At a chapter mtg I heard a manager complaining because it was difficult to find coders especially those with experience. So why not train those who have obviuously proven that they are competent enough to eventually learn how things operate? Many of these seasoned coders that complain about new ones not doing things correctly got their start w/ no exp. and no schooling so stop being HYPERcritical. 
The CPC test is hard, not as hard as the CCS though, but employers even overlook that if you have no experience. It is not about the exam needing to be more difficult. The intention of the exam was to increase the salary for someone already in the field or to prove your exp. Unaccredited schools mislead us into thinking this exam would get us jobs. Let us newbies just take the RHIT, RHIA or just some billing exam to try to get into this field. It is a very competitive industry I think mainly because of strict regulations.


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## terriwarren

I think there have been good points made on both sides.


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## kevbshields

Another vital piece of the discussion is that issue with internships.  Here are the concerns I have in regard to internships:

1.  It can be very hard to locate internship sites willing to take students; I've heard some say, "we'd like to," but follow that with "not now."  If the school cannot find partners to commit to these internships, there are none to offer.

2.  Even when schools have internship sites, it only takes one student to end that relationship.  I've also seen this happen.  Whether it is someone with an excessively ill child or a student who does not know how to act in a professional environment, any mis-steps and the program loses that site, regardless of the reasons.

3.  Having taken many student interns over the course of my time on the clinical side, students sometimes do not fit into the iworkplace environment.  It can be about personality, expectations, reliability, speed, accuracy or any other number of elements.  Point being, I took one intern for an extended period of time and advised her to complete credentialing, then she might find a spot at our facility.  To this day she has yet to sit for a credential.  Internships do not solve the problems.

4.  Some of the work completed on internships is only as meaningful as the student's efforts.  Depending on the program of study and faculty, a student might answer the phones at chiropracter's office 3 days a week for one semester; another student might completely gut a records room and write the business proposal for hiring scanners to close the file room permanently.  Those are very different experiences.  Let's not forget that an internship at some health care organizations isn't worth putting on a Resume; we know about other organizations within our local area, some of which we want nothing to do with. 

Anyhow, I'm certain there might be other perspectives out there.  These are a just of a few of the more important ones that come to mind when we discuss the prospects of a little experience.


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## Pam Brooks

kevbshields said:


> Another vital piece of the discussion is that issue with internships. Here are the concerns I have in regard to internships:
> 
> 1. It can be very hard to locate internship sites willing to take students; I've heard some say, "we'd like to," but follow that with "not now." If the school cannot find partners to commit to these internships, there are none to offer.
> 
> 2. Even when schools have internship sites, it only takes one student to end that relationship. I've also seen this happen. Whether it is someone with an excessively ill child or a student who does not know how to act in a professional environment, any mis-steps and the program loses that site, regardless of the reasons.
> 
> 3. Having taken many student interns over the course of my time on the clinical side, students sometimes do not fit into the iworkplace environment. It can be about personality, expectations, reliability, speed, accuracy or any other number of elements. Point being, I took one intern for an extended period of time and advised her to complete credentialing, then she might find a spot at our facility. To this day she has yet to sit for a credential. Internships do not solve the problems.
> 
> 4. Some of the work completed on internships is only as meaningful as the student's efforts. Depending on the program of study and faculty, a student might answer the phones at chiropracter's office 3 days a week for one semester; another student might completely gut a records room and write the business proposal for hiring scanners to close the file room permanently. Those are very different experiences. Let's not forget that an internship at some health care organizations isn't worth putting on a Resume; we know about other organizations within our local area, some of which we want nothing to do with.
> 
> Anyhow, I'm certain there might be other perspectives out there. These are a just of a few of the more important ones that come to mind when we discuss the prospects of a little experience.


 
Very good points, Kevin. We had some poor experiences with interns, thus we no longer take them. It's my observation that many new coders are second-career employees, and sometimes the culture shift from one industry to another is just too difficult to overcome. I had one employee who had three years experience in coding, but came from a very blue-collar environment. I had multiple conversations about language, dress, and demeanor, and eventually the frustrations of the environment as a whole resulted in a parting of ways. Before anyone thinks I'm all hoity-toity about blue collar workers, let me say that I'm married to a union ironworker, and I worked 8 years in a factory, so this is my second career, and transitions are possible. However I will acknowledge that it almost requires a personality adjustment, and that is the kind of thing I recognized as being a distinct challenge with our unsuccessful interns and new coders.


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## MnTwins29

*A cooment on interns*

While these are excellent points about what the intern should expect and LEARN while at the facility, it is also important that the facility takes on an intern with the intent of teaching that person a skill or trade, not that the person is unpaid help.

When I was studying for the RHIT, we had to do two PPE's, similar to interns.  I did one at a substance abuse facility, in which I was nothing more than an unpaid file clerk as I spend the time filing loose papers, picking up charts etc.   I "cheated" and read the papers I was filing to learn more about HIM, but no one was there to answer questions, etc.   My other PPE was at a hospital in which the HIM director actually took the time to sit with me and show me how the department works.   I was very grateful for that, and wrote a thank you note when the internship ended.   She then hired me as a per-diem outpaitent coder, and from there the beast grew!  

My point is this - both student and teacher/facility need to have the proper expectation for an internship to be productive.  

This is a good discussion.   Like Pam, I have been on both sides here and have thoughts - but will space them out to allow others to speak out as well.


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## kevbshields

Lance,

This is where you and I differ a bit.  When I completed my internships (PPE) for the HIT, I wanted to be an unpaid consultant for my sites.  In fact, I intentionally sought out an organization with which to work in that capacity.  Was I there to learn more about that setting?  Yes.  At the same time, I had valuable skills, knowledge and experience to offer that site.  Since being "unpaid help" is very subjective, I see no issue with it.  The student should learn something from internships, it'll just be more learning at some facilities and opportunities than others by comparison.  Regardless, what one student sees as a valuable practice experience, another will sense as a form of servitude.  

My point was that students shall sometimes make their internship experience.  That is, some go in and move mountains while another barely moves around the office.   Try as we might to push students to challenge themselves and identify solid interning sites, it ultimately falls back on what each individual student has to offer to that site.  Again, I've seen one intern who was more preoccupied by rearranging spreadsheets than learning coding; another worked for me for months on a behavioral health coding project and grew professionally from a coding and compliance standpoint.  I certainly agree with Pam on the cultural piece of it:  health care entities have their own atmosphere, and sometimes a worker, student, manager or consultant just does not fit in.


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## MnTwins29

Kevin:

We really aren't that different on our views, especially when it comes to what the student wants out of it.   That was why on my first PPE I spent time reading the papers I was filing, trying to learn something instead of mindlessly filing.   I was disappointed the director wouldn't spend more time with me, but at least I was able to take something away from it.   The few times I have been able to be a mentor or have a student or intern assigned to me, I make sure that he or she is engaged - if that person WANTS to be.


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## snowbird100

*Will passing the CEMC help me get a job.*

I also am hitting a brick wall.  I received my CPC 10/12  and I am doing volunteer insurance billing for a counseling center.  I would like to become a EM specialist.  Is that possible without any on the job experience?  I thought I would take webinars related to EM's and pass the CEMC.  Or would my time & money be better spent forgetting the EM specialty and going for a RHIT or maybe a CPC-H.  Thanks for your insight.


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## MnTwins29

*One person's opinion*



snowbird100 said:


> I also am hitting a brick wall.  I received my CPC 10/12  and I am doing volunteer insurance billing for a counseling center.  I would like to become a EM specialist.  Is that possible without any on the job experience?  I thought I would take webinars related to EM's and pass the CEMC.  Or would my time & money be better spent forgetting the EM specialty and going for a RHIT or maybe a CPC-H.  Thanks for your insight.



For specialties, I believe it is best the other way around...if your current duties are geared toward a specialty, then get certified in that specialty.   If not and you are looking for employment in general, then the "core" certifications are best (CPC, CPC-H, CCS, etc)

That is the road I took - CCS-P and RHIT for a long time....didn't take CEMC exam until I was doing E/M auditing for awhile.   Since that was assigned to me, I figured I better show that I knew what I was doing!


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## chayawieder

first of all, AAPC has a program where they will help you get externship. If there is a place in your area you want to do externship, AAPC will contact them and offer them some freebies in turn for an opportunity to give you the externship.

Also I have heard this time and again. You should be applying to ads that ask for experience, chances are they will NOT get a better application than yours... it has worked for many!

good luck


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## snowbird100

"first of all, AAPC has a program where they will help you get externship. If there is a place in your area you want to do externship, AAPC will contact them and offer them some freebies in turn for an opportunity to give you the externship."

The two extern opportunities listed in my area no longer accepting applications.  One has been asking AAPC for two years to remove them from the list.  I have also notified AAPC.  I have no idea why they have not taken care of this problem. Thanks for your advice.


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## LaVoncye

*AAPC credentials CPC or CPC-A*

To whom ever this may concern. Really it doesn't matter if your a CPC A or CPC if you don't have at least 3 years of hands on coding no one will look your way. It's not fair for those who have the experience to talk down on those that don't. The CPC A's and CPC with no experience studied, stressed, and took the same test everyone else did. There are some who have made there way and others who need a chance to do the same. It is awful we are supposed to be a family and support each other. In order to get to a certain level no matter what field your in someone has to care enough to believe. Remember those who are in a position where you can bring someone under your guidance but chose not to because you are a expert coder now, someone believed in you and gave you a chance.


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## sbziggy3

*I feel your frustration!*

I became a CPC 10 years ago. I have had trouble getting a foot into the door. I've got years of medical billing experience. I thought maybe I needed more education so I spent $30,000 getting an Associates of Applied Science in Health Information Technology. I studied hard graduating with a 3.82 GPA and got credentialed as a Registered Health Information Technician (RHIT). I graduated in March of 2012 and still have not found work! I agree! They need to make these colleges have coding extern/intern programs. I am determined to keep trying but it is difficult! I am trying to keep current on coding by using programs on the internet while I wait. I've appled for hundreds maybe thousands of jobs!


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## sbziggy3

Please give new coders a chance!!


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## CJ4185

mitchellde said:


> I do not thing the exam is the issue nor is the certification, I think it is the quality of the worker.  The employer is wanting to hire a proven worker someone with experience that can get the job done.  And who can blame them, time is money afterall.  I think the problem is the application process, too many times when I have looked through applications I see individuals that feel entitled to have the job, just from the way the cover letter is worded, the resume is arranged.  I am suppose to hire them because they are entitled to this job.  I turn that down.  I also see ones that beg and plead, I turn those down.  I am looking for someone to benefit me, I am not there to benefit you.. You see how they think?  SO I look for a resume and a cover letter where this person is telling me how they are going to be asset for me.  As an applicant I write my cover letter and resume to reflect how I will be an asset for the company.  I even tell them this in the interview, I let them know I am there to assist them.  I have never been turned down even when I had little to no experience, nor have I ever turned an applicant away that can be that bold and aggressive.



Truer words have never been spoken.  

I have a 2nd interview for a Coding Special I job coming up next week. I have zero coding experience but passed a 10 month coding course and the CPC exam my first try.  

I have worked in the same hospital as i'm applying for a job at, for the past 9 years as a Transportation Orderly.  I can 100 percent say the only reason i'm progressing through the application process versus some other people I know who have better resumes is because the hospital knows that i've been a valued and hard working employee for the past x amount of years and they want to see me succeed for them over some other hospital.

Get your foot in the door, whether its accounting, or medical records, or patient administration, or fiancial services, or the hospital service industry.  Make the hospital want to keep you, because they know you're an asset. 

Christopher Jones, CPC-A


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## AB87

terriwarren said:


> Things need to change in the professional world. I graduated from Sanford-Brown Institute's Medical Billing and Coding program in 2009. On the second try, I got my CPC-A in 2010. Unfortunately, Sanford-Brown didn't have an externship program for MBC, so I was not able to get any actual experience. That is the ten-foot thick concrete wall I have been hitting. I have applied for a variety of positions, not just coding, just to get my "foot in the door," and hear the same thing over and over: "Minimum two years' experience required." This has to change if new coders are to actually GET that experience. I have even seen positions that are open for long periods of time, because they are turning down new coders, waiting for experienced coders. Wouldn't that time have been better spent training a new coder for the position? If that were done, then the organization would have known they had someone who knew how to do the position to their satisfaction.
> 
> New coders deserve a chance that they are not getting. Currently, I am volunteering at Laurel Regional Hospital. It is not in any area that will help my search, but I am working with the Volunteer Coordinator to move to an area that will. So I am not giving up, but it has been an uphill battle trying to find a position to get my career started. A battle that is not over yet, and has no end in sight. There are very few positions I can do in the meantime, because I am disabled.
> 
> It seems a shame that I struggled to go to school while living in a homeless shelter, graduated with a 3.88 GPA, only to not be able to find a position now that I am graduated and certified. I really need someone to read this post and respond. I need to know what to do now. I have been struggling on my own since I graduated, and even before. Please help.






Hello TerriWarren. I went to sanford-brown also and by the way which one did you go to? I got my start here in Orlando with a Derm Company. I went on alot of interviews and was turned down because i had no exp when i had my CPC-A. In jacksonville where i lived m whole life i see that ALL Coding jobs do not accept CPC-A's. I feel your disappointment.


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## mmhubb

*...*

I know you prob won't want to hear this but...sometimes you have to start at the bottom. I have experienced your exact problem. I too graduated from SB (2005) and no one wanted to hire me. Fortunately for me I landed a job at a hospital as an ER registrar, which had absolutely nothing to do with what I went to school for. However, I used that to my advantage and asked my supervisor to help me with internships on my own. Since then I have landed a billing job which still doesn't allow me to code as I would like, but I will use this job as an experience inhancer for my resume. 
Anyway, the point that I'm trying to make is that starting at the bottom may get your foot in the door. It may not seem like it but you may be surprised at the opportunities that you may have access to that way. If it had not been for the ER reg super, I'm not sure how I would have gotten the chance to meet the ppl that gave me awesome advice on how to move fwd. It may not be moving as fast as I would like, but like you I am constatntly on a hustle to moving up to be where I want to be in this field.
I wish you the best!


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## tams1225

*New Coders*

As a long time coder and HIM professional (RHIT, CPC, working on my Bachelors), as well as hiring supervisor and manager, I have found that job seekers who went to a business school such as Sanford or Brown Mackie or whichever, do not adequately prepare students to pass the exams let alone code a complicated record.  With the ever changing and stringent regulations, facilities need to hire the best possible coders and sadly the reputation of these schools often haunts students.  

Where I have worked we have used the pre-employment coding exam as a gauge to whether or not the applicant has basic knowledge of the guidelines and how to code.  A good score on the exam will definitely get them a second interview.  If you go in with confidence, a good score, and sell yourself as to what you can offer the facility after brief training, your odds will be greater.  If you go in dejected that will show.  Also, employers do check boards and social media, be careful with what you post.

A CPC-A or even a CPC with no inpatient experience does not have high hopes of getting an inpatient coder position these days.  It really angers me what these business schools promise.  Please be sure to do the research on these schools as they will not give you honest answers on job placement.  Most employers are looking for AHIMA credentials, not AAPC, and there are very good programs that are AHIMA approved and quite a bit cheaper than these business schools.  A good rule of thumb is that facilities hire AHIMA credentials and physician offices or other outpatient facilities hire AAPC.  

It is naive to think or expect that an employer would provide a remote job to an unproven employee.  You will often have to work onsite for a good amount of time to prove that you are dependable, knowledgeable, productive, and confident.  If further education is needed, they will want you onsite.


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## corikr77

Have you thought of volunteering to get some experience? It can also help you remove the apprentice status on you certification, and shows potential employers your committment to the profession. You may also have networking opportunities to job openings through the volunteer job or at least you will have an added reference to reflect your capabilities.


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## MnTwins29

CJ4185 said:


> Truer words have never been spoken.
> 
> I have a 2nd interview for a Coding Special I job coming up next week. I have zero coding experience but passed a 10 month coding course and the CPC exam my first try.
> 
> I have worked in the same hospital as i'm applying for a job at, for the past 9 years as a Transportation Orderly.  I can 100 percent say the only reason i'm progressing through the application process versus some other people I know who have better resumes is because the hospital knows that i've been a valued and hard working employee for the past x amount of years and they want to see me succeed for them over some other hospital.
> 
> Get your foot in the door, whether its accounting, or medical records, or patient administration, or fiancial services, or the hospital service industry.  Make the hospital want to keep you, because they know you're an asset.
> 
> Christopher Jones, CPC-A



Mr. Jones,  I certainly hope your facility repays you for your loyalty and didciation with that position.   Your work ethic and positive attitude toward your employer is certainly worth the weight ot 10,000 certifications.   Please keep us informed on your progress.


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## NanaT

*Frustration*

Sorry to hear of your dilema, unfortunately I graduated from MedTech College and we had an externship program but that still doesn't matter to anyone that is hiring for experienced coders. I was on the Dean's list every quarter but 1 and I was on the honor roll that quarter...even that didn't matter...I busted my butt to get good grades and I passed the CPC exam on the first try...I finally found a job in coding and I love it!!! I guess just be persistant and do what you can to  stay current on the coding and changes. Good Luck!!


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## Pam Brooks

mmhubb said:


> Fortunately for me I landed a job at a hospital as an ER registrar, which had absolutely nothing to do with what I went to school for.


 

mmhubb, let me use your example to make a point. ER registrar positions (or any patient access positions) are the starting point of the revenue cycle. The patient information you gather (or fail to gather) at this encounter is crucial to the success of the revenue cycle. Understanding that concept will be vitally important as you move into coding and billing. If you didn't learn that as part of your revenue-cycle training at your school, they didn't do a very good job, in my opinion. Don't sell yourself short, and certainly don't discount this job as having been a meaningless experience. 

For every would-be coder out there here's some advice: The more you know, and the more you understand about the process, the better positioned you will be to become an important resource as you move upwards in this industry. Patient access is probably the most important function within the revenue cycle, and you should be proud that you have this opportunity. Don't be reluctant to begin in any healthcare capacity, regardless of how un-relevant it may seem at the time. All work experience is valuable, and nobody (not even me) started out as a coder.


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## dclark7

Pam Brooks said:


> ER registrar positions (or any patient access positions) are the starting point of the revenue cycle. The patient information you gather (or fail to gather) at this encounter is crucial to the success of the revenue cycle. Understanding that concept will be vitally important as you move into coding and billing. If you didn't learn that as part of your revenue-cycle training at your school, they didn't do a very good job, in my opinion.
> 
> For every would-be coder out there here's some advice: The more you know, and the more you understand about the process, the better positioned you will be to become an important resource as you move upwards in this industry.


 
I would like to add this to Pam's message.  To be a good medical biller you must know coding and to be a good coder you absolutely have to understand billing and the revenue cycle.  This is where I think many schools fall short, they don't spend enough time on the billing and revenue cycle and how coding affects it.  Many new coders are so anxious to get right to the coding without really understanding how all the pieces fit together.

Pam's advice is right on - learn all you can, don't discount what you'll learn in that front desk or patient registration position you might have to take.  This is the beginning of a long journey and the more you know the more valuable you become to an employer


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## lschill652

I thought i was the only one thinking that.  If I had known that you needed two years experience I wouldn't of wasted my time doing these courses.  I feel for you girl.


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## mitchellde

mdunn said:


> i totally agree with one of the earlier posts that the percentage required to get a passing score on the test should be raised. If a coder had a 70% accuracy rate at their job they would be fired in a heartbeat. I also think there should be at least a fill in the blank section if not the whole test fill in the blank. You have no multiple choice when you have to code on the job.
> People do feel entitled to the coding jobs just because of passing the exam. You have to start at the bottom and work up. Doctors office front desk, billing department etc. I feel people think coding is way easier than it really is and are not prepared to actually do the work. The school part of is a joke from what i have seen. The instructors aren't experienced coders a lot fo the time. They just follow a lession plan, but don't really know the first thing about coding.



Just so you know I am a coding instructor with more than 30 years experience as well as current coding ongoing, so not all of us instructors are clueless.


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