# Too Much Competition?



## mchllshrms (Jun 23, 2012)

I think that due to the over-saturation of coding certificate programs, advertising, or even news articles, there has been a surge in the number of aspiring coders trying to get into the business. For about the past 10 years or so, coding was "the" job field to get into because of supposed demand.

I was trying for one coding position in a hospital and was told that they already have a "plethora" of level I coders who have taken and passed the assessment, so they wouldn't be be needing to look at anyone else for now.

Everywhere you turn, employers can afford to be "picky" by demanding that coders have ____# of years experience, certain specialty certifications and certifications from various professional organizations.

So while newly certified coders bemoan the fact that they can't get experience or even get their "foot in the door", I think the real problem is that there are just too many of us out there vying for a limited number of positions-especially made worse by outsourcing(and on an side note, I commend the efforts of organizations such as AHIMA to discontinue testing and certification of the CCS for residents of India and the U.A.E.)

What do you think?


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## mitchellde (Jun 23, 2012)

mchllshrms said:


> I think that due to the over-saturation of coding certificate programs, advertising, or even news articles, there has been a surge in the number of aspiring coders trying to get into the business. For about the past 10 years or so, coding was "the" job field to get into because of supposed demand.
> 
> I was trying for one coding position in a hospital and was told that they already have a "plethora" of level I coders who have taken and passed the assessment, so they wouldn't be be needing to look at anyone else for now.
> 
> ...



I know that on one level you are correct and the sheer number of billing companies has in fact contributed to this.  Many billing companies employ only a few actual certified coders , if any.  I know some are going to respond and state that is incorrect.  However I work in many different capacities and one is that of auditor.  I have at the request of numerous providers performed audits of their billing companies that profess to use only "qualified billing and coding personnel"  one even stated only AAPC certified, the problem is this has in all cases been a false representation.  The one that was using the AAPC statement had no certified coders at all, one was a front for off shore billing in Pakistan and none were certified and far from qualified.  None that I have audited to date can meet the true letter of what they represent.  It is truely sad that physicians have suffered financially from this type of business.  I know there are probably reputable billing companies out there but I truely have never found one.  Remember a billing company can be anything from a huge multi employee organization to a one person shop working from home.  But I feel this is where all the coding jobs are going, have gone.  Billing companies that take the jobs but hire no certified coders.  
Sorry I just had to vent!


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## kml1764 (Jun 23, 2012)

While I think that there are a lot more new coders graduating the various programs, I think that there are way too many that are trying to get right into a coding job.  As frustrating as it may seem, I think the best way to get yourself to a coding program is starting from the bottom.  Get your foot in the door...look to work as a medical receptionist, in medical records, whatever.  I believe that most coding positions open will first look to internal employees.  It's more financially advantageous to employers because they have already invested training of these employees within and also they can do a more smooth transition in getting that internal employee able to work as a coder.  The more versatile that you are (handling other medical office positions), the more valuable you are to employers.

Just my 2 cents!
Kris


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## mcnaryk (Jun 23, 2012)

Kris-I completely agree with you about getting in on the ground level. I started as a medical receptionist, and gradually learned the inner workings of a medical front office from insurance to referrals to charge entry. Working charge entry, I became interested in coding, and was put through a coding certification prep course through work. Having had the prior medical office experience I was able to test for the CPC and not the CPC-A which I also believe helps a lot. I guess my advice would be to hang in there-if you are newly certified and unable to get into coding right away, try for a job in a medical office. It will add on to your experience and understanding of insurance and coding, and quite possibly lead to a coding job since most places hire internally first. Good luck!


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## mchllshrms (Jun 24, 2012)

Yes, but how will such a "get your foot in the door" position in a hospital help you to get a job as a coder in the same hospital when the requirements are so stringent-i.e. must have X# years experience in an inpatient coding environment, must have graduated from an AHIMA approved program, etc.?

I don't think a job as a receptionist will help you in the long run as a coder when you never touch a code the whole time..


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## rthames052006 (Jun 24, 2012)

mchllshrms said:


> Yes, but how will such a "get your foot in the door" position in a hospital help you to get a job as a coder in the same hospital when the requirements are so stringent-i.e. must have X# years experience in an inpatient coding environment, must have graduated from an AHIMA approved program, etc.?
> 
> I don't think a job as a receptionist will help you in the long run as a coder when you never touch a code the whole time..



I think Mcnaryk's story explains how a job as a receptionist helped her in the long run.  When you understand the entire billing/coding process it really does help.  It starts with that receptionist who gets that patient phone call for an appt and evolves from there.

I've see where someone from the "inside" gets the job over an outside applicant because some companies believe in "promoting from within" with someone who knows how that company runs/works.

When I started off as a biller and knew nothing about coding, I used to read op notes in our patient charts and code from them, it was real life experience and not a quiz from class, a real live op note.  Keeping yourself up to par on billing and coding speaks volumes in and of itself when you aren't employed as a coder per se'.  Look at every position as a stepping stone to your final destination. I've always found myself being thankful for the way I got into this field ( by accident) and I kept building off that foundation and now I am in a position that I absolutely love!  It took me 5 years from the date I got my CPC to land/obtain a true coding position.  

For those of you in the struggle, the best advice I can give you is to keep current on your coding, there are several free sites where you can keep this up without having to dish out any money; your Local Medicare Carriers- most have webinars and workshops free of charge that you can attend, lunch and learns, your local chapter. Network with your local chapter members at monthly meetings, find a mentor.

Some of the best coders are the ones who know how to keep themselves up on the happenings.

Best of luck to you all.


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## kml1764 (Jun 25, 2012)

rthames052006 said:


> *When I started off as a biller* and knew nothing about coding, I used to read op notes in our patient charts and code from them, it was real life experience and not a quiz from class, a real live op note.  Keeping yourself up to par on billing and coding speaks volumes in and of itself when you aren't employed as a coder per se'.  Look at every position as a stepping stone to your final destination. I've always found myself being thankful for the way I got into this field ( by accident) and I kept building off that foundation and now I am in a position that I absolutely love!  It took me 5 years from the date I got my CPC to land/obtain a true coding position.
> l.



Hi Roxanne,

How is the opportunity to start as a biller?  I'm going to be starting a billing and coding program this coming August (1000 hr course).  Is there a good way to head into a position such as that?  Any help would be gratefully appreciated.

Kris


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## rthames052006 (Jun 25, 2012)

kml1764 said:


> Hi Roxanne,
> 
> How is the opportunity to start as a biller?  I'm going to be starting a billing and coding program this coming August (1000 hr course).  Is there a good way to head into a position such as that?  Any help would be gratefully appreciated.
> 
> Kris



Kris-

Are you asking what are the chances of landing a billing job?  If that is the case, my "opportunity" found me, I didn't find it!  I was working as a receptionist in a nursing home, the gal who did the resident billing went out on an early maturnity leave.  My schedule at the nursing home was a great one.  I worked 7 days on and 7 days off, they asked if I'd like to pick up some extra hours?  Then shortly after I transferred to the Billing Office.  It wasn't true "billing" at that time, what I did was received bills from offices, hospitals etc... for our residents and back then, it seemed that most facilities or offices didnt' submit to secondary carriers or else they didn't participate with them.  So I would receive those bills with what at the time I called ( a red and white form) with a notes saying to submit this to your 2ndary carrier if you have one, othewise the balance is your responsibility?  I had no clue, I remember calling York Hospital and asking them "what am I supposed to do with this red and white form" they explained to me what I needed to do and that was the start of my billing career.  True on the job learning!


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## honiebyrd (Jun 25, 2012)

I know exactly how you feel. It has been almost two years since I received certification as a CPC-A. I have walked into offices cold turkey and left my resume. I have sent my resume to all the area hospitals. I have applied for every coding job I have seen advertised on the internet. I have also applied for Medical Record positions as well as Receptionist positions just to get a foot in the door. Thus far, I have been given one interview in which I was told that her concern would be how I have "kept up" since it has been awhile since I graduated school. My certification is to be renewed in September 2012. I don't think so as I can't afford to keep paying high fees for a certificate that has proved profitless. I can not throw my family's small income around that casually. I am done with it unfortunately.


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## kml1764 (Jun 26, 2012)

honiebyrd said:


> I know exactly how you feel. It has been almost two years since I received certification as a CPC-A. I have walked into offices cold turkey and left my resume. I have sent my resume to all the area hospitals. I have applied for every coding job I have seen advertised on the internet. I have also applied for Medical Record positions as well as Receptionist positions just to get a foot in the door. Thus far, I have been given one interview in which I was told that her concern would be how I have "kept up" since it has been awhile since I graduated school. My certification is to be renewed in September 2012. I don't think so as I can't afford to keep paying high fees for a certificate that has proved profitless. I can not throw my family's small income around that casually. I am done with it unfortunately.



Honiebyrd, have you been involved with your AAPC local chapter meetings?  I'm not saying that it is a guaranteed way of getting hired, especially if you doing so just to get hired...but if you get involved, network with the AAPC members, continue learning (btw attending these chapter meetings will help you meet your CEU needs), you'll put yourself in a better place to see where needs are.  Also, it is a great way to meet with more senior members who might be willing to mentor you, help you with your resume, etc.

If you've been putting in a lot of resumes but not getting much of a return, have your resume critiqued.  

Good luck!
Kris


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## honiebyrd (Jun 27, 2012)

Thanks Kris!!!


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## pdciaralli (Jul 3, 2012)

*Coders*

I'm a coding and auditing supervisor and have such a hard time finding qulified coders we are always short staffed in patient and out patient. If an employee shows up to work on time, has a good attitude, does not gossip,and puts in an 8 hour day. I will take a new coder and train them over someone who shows up late calls in sick and starts trouble with co-workers anyday. 
Its not always what you know. What did you do at your last job or how do you come across in an interview.


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## kevbshields (Jul 4, 2012)

What the coding & auditing supervisor said in her previous post holds very true.  Sometimes an employee's personality type will not align with this type of work.  That's something the recruiters at schools, professional advisors and human resource workers cannot necessarily explain to or idenitfy for a candidate.

Instead of the field being oversaturated, I tend to think of it as being a case of misplaced skills.  Those who have coding, billing or revenue cycle backgrounds (and carry certification) can work throughout the business side of health care.  Some, in fact, straddle clinical and administrative--such as CMAs, nurses and other folks who take to our niche in health care.  For whatever reason, we are told or believe (on our own) that the only job for us is "coder."  Instead, if we taught apprentice coders how to locate jobs based not on their title, but on the skill sets, we would probably find more in successful health care roles.  Our first obstacle is to remove our reliance on hospitals as primary employers in our field.  That simply is not the case any longer.  We should be working in every health care setting, taking responsibility for a vast array of revenue functions--as we are experts in this area.  _For the Recrod_ had an article about revenue cycle management in its June 18th edition.  I'd encourage the folks looking for work or a change in our field to review that article.  Although it won't tell you how to "break into" the field, it captures our roles in the larger scheme of health care business.

With that in mind, look for positions that let you highlight the skills you've already obtained.  As someone mentioned, keeping very current on your continuing education (local chapter meetings, free webinars, independent study of topics) helps demonstrate the importance you place on the profession.  Also, do not go for the "easy" CEUs, like reading a magazine and calling it a day.  Reach out to really grow your understanding and competencies in new areas.  This might involve a serious commitment to the task of identifying affordable, yet robust learning opportunities that grant CEU credit.  Regardless, the pay-off is worth it.  The next time a hiring manager challenges you to explain how you've remained current, you will have a meaningful list of your activities and learning.  Rather than being stumped, you may be able to educate her on a topic or two.  Of course, if that seems too much for someone, again, he or she may not be well suited to this field.

Most importantly, know enough about health care to be creative in finding opportunities.  The plethora of business-related health care jobs lends itself to alignment with coding or billing.  With expanding health care coverage, I can only predict the number of roles shall increase very soon.  That gives credentialed coding professionals some advantages, so long as they demonstrate their worth and professionalism.

A manager I once knew said that "coders belong at every point in the revenue cycle", meaning that their contributions are vital to fiscal health.  Know that what each of you had to learn to pass the certification exam makes you better qualified for a number of positions with some amount of coding, billing or data capture.  You may find yourself in a role that you enjoy a great deal, that lacks the "coder" title.  And that is ok.  Not all nurses work on the clinical side anymore.


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## zanalee (Jul 5, 2012)

rthames052006 said:


> I think Mcnaryk's story explains how a job as a receptionist helped her in the long run.  When you understand the entire billing/coding process it really does help.  It starts with that receptionist who gets that patient phone call for an appt and evolves from there.
> 
> I've see where someone from the "inside" gets the job over an outside applicant because some companies believe in "promoting from within" with someone who knows how that company runs/works.
> 
> ...





Well said!!! this is how i got started, from a biller to coder. I'd also landed this career by accident and i am loving every moment of it. You need to learn to crawl before you learn to run, good luck everyone!!!


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## rthames052006 (Jul 6, 2012)

Zanalee-

I total feel you!  You must learn to crawl before you can run.  Good to know there are other fellow coders out there who landed in this field by accident and are enjoying it .


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## kimcornish (Jul 6, 2012)

I completely understand how you feel regarding the membership fee, cost of new coding books, etc. I have also been certified for over 2 years and can't even get an interview for a receptionist position. I recently became a volunteer at the local hospital in a non-coding related position. I'm hoping to eventually gain employment through networking.


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## KatHopkins (Jul 10, 2012)

Regarding getting your "foot in the door" - try your local temp agencies.  

I got sent by one of my agencies to do filing at a local hospital, just because I had general clerical experience.  Then the hospital ended up hiring me to work in Medical Records because of my computer skills (they were upgrading systems at the time and I caught on fast!)     From there, I worked my way over to coding when the opportunity arose, job postings are internal first...and I did coding for 2 years before I got any certifications.  

The wider your job skills, the better your chances.   

Having some related classwork on your resume is also a plus.  I had Medical Terminology and A&P when I got hired.


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## kevbshields (Jul 11, 2012)

The CPC-A existed well before 2006.

With any profession you can invest a great deal of time, effort, money and sacrifice, only to have it taken from you at any time.  Though I am waxing philosophical, those are the facts.  How many physicians once had a thriving practice, but due to "clerical" erros in their billing or coding lost that?  Maybe it was bad practice management or someone who stole from them.  Those cases are out there.

Oddly, every once in awhile, I run into someone very well educated (master's degree or above) and hear that he or she lost a job or had to change careers.  AAPC is not responsible for the obstacles you face in this career, nor to anyone's failures.  What we are not doing as an industry (again, has nothing to do with AAPC) is supporting novice, entry-level coders; we let hospitals and nursing homes hire nurses to do our jobs; we permit the outsourcing of our jobs to India and abroad so that we "get to work at home"; we also let our practices be run by someone with no college degree or credentials and somehow all of this is perfectly fine.  To blame the professional association is blasphemous.  If you want to do something, try finding a way to make coders and billers (or those educated for such work) more important to your practice.  Toss off the dead weight of incompetent or uneducated staff members who do not strive for the best work product.  Rise to the top and make change, then that'll be time not spent blaming an organization that supports your interests.


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## Pam Brooks (Jul 12, 2012)

kevbshields said:


> Most importantly, know enough about health care to be creative in finding opportunities. The plethora of business-related health care jobs lends itself to alignment with coding or billing. With expanding health care coverage, I can only predict the number of roles shall increase very soon. That gives credentialed coding professionals some advantages, so long as they demonstrate their worth and professionalism.


 

This is a very important point, Kevin. One of the questions I ask all new applicants is to tell me where they want to be in five years. It's clear from the answers I get ("I want to be coding"), that most new coders have no understanding of the broad scope that encompasses the business side of medicine and of the opportunities that are out there. That lack of knowledge tells me that these candidates have not done their research in this field, and that they're simply looking for a job...not a career.


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## rthames052006 (Jul 12, 2012)

Hey Pam 

You sure hit the nail on the head with that one!  When I talk to new coders ( that contact me first) they always say that they want to "code" but I will always ask them what type of coding do you like facility or outpatient? Then I get into the where do you see yourself thing and also if they say physician or outpatient side I ask what speciality interests them and as you said, the common answer is " well I never thought about that" or I nevet thought about it that way.  

I know for myself it took me about 2 years to really know what my niche was, I knew I loved e/m but found that I didn't like "production coding" per se all day....  Compliance is what I like to do mixed in with some auditing/coding.

Just my 2 cents!


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## kml1764 (Jul 12, 2012)

I'm still only a student, but as I learn more and more about coding and the purpose behind coding, I know it is more than just data entry.  Now I have worked in the medical field in administrative positions, but it isn't until now that I am realizing the business aspect.  I have high aspirations, and I do want this as a career.  Working on my bachelors degree is next on my list of education to do list.  

I know when I am done with my coding course and getting my CPC, I'm looking for a front office position.  I want to learn about the practice I work in from the ground up.  I know that when I look for a position it will be with a practice that will let me do that.  I will continue to learn and work on further certifications and show my employer that it is my goal to help them in the best way that I can.

I agree, wholeheartedly, with Pam and appreciate all of her input.

Kris


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