# Employment Testing



## talamorej1977 (Sep 22, 2010)

Good Evening. I have a question that I personally I have not seen posted. Yet, I feel the need 
to ask this question. 
Why is it becoming the standard for employers to test coders and auditors prior to being hired? 
If we are already certified, have the qualified years of experience asked for the position. Further more, 
if you hold sub-specialty credentials, why are we still asked to be tested? 
Why should we continue to get certified? Pay for our CEU's that get continuously more expensive by the year? 
Yet, we are being tested by our own peers? Some who have less credentials and years of experience. 
I understand that there should be a level of experience. But, I am not sure why we are credentialed if it is not 
enough to be hired.


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## ndhight (Sep 22, 2010)

*agree*

amen. I would like to know thoughts of employers.


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## clfbeachin (Sep 22, 2010)

I test applicants because of being burned in the past by people who stated they were experienced coders and billers on their resumes, and after being hired, proved to be very poor coders/billers. However, if they had credentials , I would only need to verify that was a current credential & I would not test that applicant.


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## mitchellde (Sep 22, 2010)

I have tested certified coders and they could not pass a simple coding test.  They complained that it was not multiple choice.  I have found it is a very good thing to test applicants regardless of certified or non certified status.  Sometimes certified codes coders lern just enought to pass the test, then they may work in a setting where they only perfrom data entry from a superbill.  When I hired a coder I wanted someone that could extract the codes from the documentation and correctly apply modifiers.   I think pre employment testing is essential.


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## kevbshields (Sep 23, 2010)

I hate talking out of both sides of my mouth, so let me apologize.  Perhaps I should begin by saying, I understand the justification for testing, but do not support its present form.

To add to what others have seen, there are certified coders who have pigeon-holed themselves into a specific setting, for example Urology.  That was their only job duty and probably the focus of their continuing education efforts.  Other skills, outside that specialty, may have been neglected and resultantly, the coder is no longer proficient in those other areas.  This is a simple example.  Another I can think of is a coder who got certified, but has no practical experience and applies for a high-level coding job--the exam may be completely out of reach because this type of coder has not developed the professional skill set to be employed in that setting.

Another problem I see is that coders certified in one area believe their credentials to be universal.  This is where you'll see CPC-Hs applying for physician office jobs.  When the credential does not match the setting, coders are asking to be tested or screened.  There are very few certifications that allow you to work in any setting (I can think of two).  Regardless, I do not believe credentials are indicators of a coder's capability--let me be clear.  Professional diversity is badly needed in HIM hospital departments, especially in outpatient coding (but that is another story for another post).

With all that being said, the industry has gone crazy with "screening tests".  These tools will be outdated; the answers are sometimes viewed as absolute, when we all know coding can at times be highly subjective.  Employers will allow recruiters and people without any sense of coding administer these tests and then never follow-up with the test taker.  In my opinion, employers should want to attract coders to their organization, not run them off and create a sense of exclusivity.  However, I am obviously not hiring at these places.

If I were to create some sort of screening test for potential workers, it would help to cull out those who are not qualified for that type of coding; but I would be more impressed by a coder who challenged the test than ones who guessed their way through or even got a very high or perfect score.  It's a shame that we've created both of these HR issues.  It's also up to us (professional coders) to fix them.


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## dirwin (Sep 23, 2010)

*to be certified or not?*

I am educated in medical coding, my aspiration was to find work I could do at home, but I am finding out that the ads for work at home doing medical coding are very misleading, if not outright dishonest!  I have no practical experience, except the short internship I did as part of my classes.  I have taken the certification exam 3 times, going to take it again in Nov. But I have decided is I don't pass this time, I am just going to seek employment in a medical office.  But what positions should I pursue that could work into getting medical coding experience.  I have a good mind for this career, it has been much more of a challenge to break into than I had ever imagined.  is there any On the Job Training available?  I am qualified for subsidy through the state of MO for that.  In my estimation of the shortage of coders, (or is that a fallacy too?) why is it so difficult to find an entry level position?  Or do entry level positions even exist in Coding? I understand the reason for accuracy and speed, but it seems to be a catch 22, no experience no job, no job = no experience.  How do I get experience? 
I entered this journey to upgrade from general clerical work, and the more I learned the more I enjoyed it.  I love Biology and English in school and this seemed to be an excellent match for the two.  
Does anyone have any tips on where I should go from here?


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## talamorej1977 (Sep 23, 2010)

Thank you all for your responses. 
Kevin, you are absolutely correct in what you are saying. I cannot agree more with everything that you have said. 
I can understand that there are companies that have been burned by coders that are certified and do not measure up to what they say they can 
do when they are hired. Shame on those individuals that have done that to this industry. But in what other field do individuals that are certified or licensed 
have to take a test prior to being hired? Once you are licensed RN you do not have to take a pre-test to work. MA, Police officer, etc. This is a silly practice that
we have allowed to happen. 
My advice to employers, look at the years of experience on our resumes. Look at our credentials. If I was able to pass my CPC and all of the other subspecialty 
exams behind my name. Then I am qualified. Testing me, and everyone else; is degrading each test that we all have taken. 
What is very sad, is this industry has a large amount of work being taken over seas? This industry needs leadership to stay strong. To work together. The future of HIM
is going in multiple different directions. So many people I know are leaving this industry in order to find something more stable.


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## talamorej1977 (Sep 23, 2010)

*To Dirwin*

Outside of all of this crazy stuff!
When I didn't work from home. I worked for a large multi-speciality group. I had students from the local college come in all of the time to finish there hours. (It was a the Medical coder/biller program)
Are you doing this type of schooling? 
My advice and opinion is this:
What type of coding do you want to do? Office or hospital
They are very different types of coding. Once you know what you would like to do. Then concenetrate on being in an office type setting for a year. If you can find an office that does surgical, office and ancillary then you are good to go. Sit with their coder for this time frame. THEN, test yourself. After they have been coded. Take a stack. Try to code them. This is the best way to start to learn. Take out the ones that are not correct. Look it up in your CPT book and ICD-9 book. Get a good medical dictonary. Learn from your mistakes. Get a good notebook. Write down if you make a repeat mistake and flag it next to that code. I promise you won't do it again. It is just like a CPT reminder. 
2.)If you have local meetings in your town. Try to attend a couple. You can get a local idea of what companies may let you come shadow people. This is another way of getting a second look at another specialty. 
I was very very lucky and had a lot of specialties from the start. 
If you LOVE what you are doing now. Then don't give up. Just go in prepared. With a lot of knowledge. Although one thinks that speed in the exam is key. You will find that it is knowledge of the book, anatomy and experience that gets you through. 
There are so many practice exams that you can take online. Start to take those. 
If you have an office that will let you shadow them in office procedures. That will also help you understand procedures as well. 
Personally I do auditing, which is my passion. But, I do it because I want to help physicians be able to practice medicine. Help patients like they should be able to. Not worry about counting points. You just have to find what you really want to do.


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## dbell1 (Sep 23, 2010)

talamorej1977 said:


> Thank you all for your responses.
> Kevin, you are absolutely correct in what you are saying. I cannot agree more with everything that you have said.
> I can understand that there are companies that have been burned by coders that are certified and do not measure up to what they say they can
> do when they are hired. Shame on those individuals that have done that to this industry. But in what other field do individuals that are certified or licensed
> ...



I agree, it is getting really crazy with all the testing that is needed to get a job.  I agree if you have your credentials and the years experience it is degrading to have to test to get a position.   I am seriously thinking about starting my own coding business just for that reason.  I like the business, but it seems companies are making unreasonable demands on seasoned coders.  I also don't appreciate the test that AAPC is going to make available to companies so we have to take one more test.  This certification thing seems like a whip out.


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## talamorej1977 (Sep 23, 2010)

I agree. I had NO idea that the AAPC was going to launch a test for us to take for employers. I posted this based on other issues. 
However, when I saw the email today that they were going to set up a site for us to test for employers. Well, what does it say for 
the AAPC when they are testing us for employers? 
I am REALLY not happy about this.


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## astephens (Sep 23, 2010)

*testing*

everytime i have been interviewed and hired i have always been honest about my knowledge. i like to keep an open mind about everything, i always say that in spite of my credentials i dont know it all, perhaps a couple of things more or just the same, i also make certain they do understand i have weak areas and not so favorite ones,  i always ask about the settings of the facility/hospital or ASC as they all have their own ways of doing things. I had a terrible experience when i applied for a position a while back and without notice got tested on hospital coding. Prior to my interview i had called the person who set up the interview and asked  if there was going to be any sort of testing to which she said no and when i was interviewing i made it clear my experience in the inpatient settings was very poor but open to learn it if needed. they still tested me and out of 14 questions I was only allowed to have one mistake. I answered my questions based on my ICD-9 book i failed, because i got 3 mistakes, i was devastated later on i found out there is a group of coders passing along the answers for the people they want to hire. to add even more I was not even allowed to discuss my mistakes. I dont have any desire of working for a company with such poor reputation. 
it is upsetting because a lot of us are very passionate about our jobs, whereas for some other ones it is just another job, or more money.


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## nsteinhauser (Sep 23, 2010)

SO - if pre-employment testing is to become the norm, why even pay ahead of time for the credentials  / certifications and the CEU's?  If you have to prove your knowledge ANYWAY, why pay to prove it ahead of time?  Seems redundant.  But maybe I'm not understanding this...???


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## mmorningstarcpc (Sep 24, 2010)

Kevin, great post!   While I might not like taking these coding tests, I do see the necessity sometimes.

If you are given an employment test and disagree with an answer, do challenge it, in a professional manner. 

I was given a 10 question test from a prospective employer, for which I got 9 correct.  That 10th one bugged me, especially when the manager stated everyone has gotten that wrong.  I went home and looked up the code she stated was the correct answer.  I then went back and looked it up again, via the index, and then the tabular section, just as I had at the test.  I came to the same answer again.

When I wrote my thank-you note for the interview, I laid out exactly how I came up with my answer.  The manager called me the next day, admitted that someone else had created the exam for her, clarified she was not a coding expert, and hired me for my initiative in researching it.  After all, why did I need to know that code and the correct answer, especially as it wasn't even related to the specialty of the practice.

Take the initiative, if often pays off!


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## ohn0disaster (Sep 24, 2010)

I completely understand that testing for a job that you've already gotten the credentials for, through testing, seems redundant BUT I also completely understand why a company would do such. I've come across many coders, certified, that really have no idea what they are doing, whether it be from lack of a medical background or something else. If you are confident in your abilities, you should have no problem passing a pre-employment test. If you are told that your answer is incorrect but you're sure that your answer was right, I agree with Machelle completely, challenge it. Do your research and let the employer know why you feel your answer was the correct answer.

I, primarily, code HCC/MRA so a lot of times I just think about it from that standard. Put yourself in the shoes of the employer. How would you like to hire someone only to find out after 6 months that they've been over coding or under coding, only to find out during validation? No bueno. The company that I work for now does a pre-employment test for that reason. In the past, the coders were instructed to send 10 coded encounters, for every doctor in their office, every week. Everything seemed fine. Come to find out during validation, the coders were sending the easiest encounters to code that they got, knowing that no mistakes would be found. Never knew there were mistakes untill it was too late. These are certified coders I'm talking about. It happens. 

Good luck finding work out there, to all of you. I hate to read all these posts about people having a tough time finding work. Just try networking and getting that foot in the door.... and DON'T GIVE UP!


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## talamorej1977 (Sep 24, 2010)

I want to clarify what my original statement.
At the end of the day, each of us can remember someone or a story of a time that we had a disaster from a "coder" that did 
something incorrect. Each of us can give an example of someone who is certified that was able to pass the test after taking 
it more than the initials they earned. I as well can think of times that have made mistakes. No one is perfect.
From the stand point I am making is this, I took my test 10 years ago and passed the first time. I waited until I had the years of experience 
under my belt to move forward into subspecialty exams. Again, in which I passed. 
What I think is not correct, is that when I do get an offer for employment that it comes with a test. That I will have to do on my time and dime. Without a guarantee of being hired if I pass. Throw us some CEU's at least. I am not intimidated by being pre-tested. I just don't understand the concept. 
As I stated in my prior comments, why should I continue with my CEU's, with my certifications and memberships when I am going to have to be tested irrespective of my credentials? 
The bottom line is this, in no other field is there pre-employment testing. 
Instead of our credentials being belittled. What ever happend to the concept of training?
Not to be disrespectful, but HCC coding is VERY difficult. It does take a lot of time to get use to and understand abstraction, mapping and taking out the rules of everyday coding. I have been doing it for two seasons and the rules change so much. There should be a credential for this!!!!! I have three binders just to refer back to. 
Everyone have a great weekend.


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## kevbshields (Sep 25, 2010)

Let me add to this, that when employers construct these exams, they should categorize scoring.  The test can then be used to assess potential employee weakenesses and strengths.  This construction also assists the employer in developing the employee.  Quite frankly, any test that doesn't have sub-sections would be questionable in usefulness.

What's helpful is that AAPC has entered the field and can provide a more sound authority source for assessments.  I'd rather take an Academy-sanctioned assessment than one with more nebulous origins.


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## talamorej1977 (Sep 26, 2010)

Again, Kevin. I agree with your points.


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