# Frustrated coder



## Ldwire (Oct 3, 2012)

Most of the job openings now are for Outpatient and Inpatient coding. Where do you get that experience? No place ever wants to give you a chance to learn. Everyone that does  outpatient and inpatient coding had that chance to learn. Does anyone offering that on the job training?
  I have never done that, and without the experience its impossible to find a coding job.


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## Pam Brooks (Oct 3, 2012)

Your CPC certification can translate to outpatient coding (with some additional training), but inpatient coding is an entirely different process, and requires additional training and usually a CCS or other certification from AHIMA. The truth is that most facilities typically look for an AHIMA-certified coder when hiring for the facility coding department, because the coding is quite different. They focus much more on disease process and diagnosis coding than we'd ever dream of in pro-fee coding, but they don't have the procedural coding expertise that we do (hospitals typically order-enter many of their procedures) Hospitals that employ physicians, however use Professional-fee coders such as CPCs, so your larger health systems generally hire CPCs. 

When employers say you're not qualified for inpatient coding, they are correct, but don't take it personally. Most just really don't want to bring someone on that they have to train right from the get-go. Inpatient coders generate big bucks for the hosptial with their knowledge of DRG assignment, and they make big bucks as well, so you can't expect them to hire folks without that skill set. Inpatient coders can train on the job, but they first have to have the related skill set (different from CPC) that they learn through an AHIMA-approved program offered either online or through a community college. Still, completing that program does not guarantee a job, so CCSs, RHITs and RHIAs don't have it any easier than we do. Just because you're a "coder" doesn't mean you can tackle any kind of coding. I couldn't abstract a DRG if my life depended on it, but I know where my skills lie, and would never apply for an Inpatient Coding Manager's job. It's not my area of expertise, and I'd set myself up for failure. 

In your case, I wouldn't shoot directly for a coding job, but would look for some other position within the revenue cycle or in Medical Information. This places your foot in the door, and will give you an opportunity to show your initiative and coding knowledge. Think about it...if you were a plastic surgeon, would you apply for a job as a vascular surgeon? No...because the credentialling and training are entirely different. The same goes for coding. Look for jobs related to coding (both physician and outpatient) in front desk, registration, administrative assistant, medical records clerk, payment poster, biller, collections staff, customer service, EHR technician, data entry specialist, scheduler, or pre-certification. These jobs are not coding jobs...but your experience in any one of these jobs will move you closer to a position in coding. The truth is that it's extremely difficult to get a job in coding without experience, so you have to think outside the box.

Stay focused and positive, and get involved in your local AAPC chapter. I've hired several coders in my department after having met them at chapter meetings. Good luck.


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## WilloKeays (Oct 3, 2012)

I wonder if those offering advice to others to "get their foot in the door" in a billing or records position are out of touch with reality.  Those jobs now also require 2 years experience.  There are no more entry level jobs in the Medical Information field.


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## kevbshields (Oct 3, 2012)

No, I don't think the people who are kind enough to take time out of their days to share career advice are out of touch.  In fact, they are counting of non-healthcare workers to develop entry-level skills prior to entering an area of industry faced with rather strict, fast-changing rules and develop a basic understanding of the work done in other areas of health care.

What you see on job vacancy announcements is a wish list, not a set of inflexible criteria.  It is meant as a guidepost to describe the ideal or minimally qualified candidate.  However, many jobs ads that state a desired amount of experience may be willing to trade that for a candidate who shows excellence in other areas, or the right attitude.  To add to that, people with 2 years of experience as a receptionist or medical record clerk, or working claims follow-up may be looking for opportunities further up the ladder--most, I'd say are seeking their next step.  If that's the case, the employer will need to fill the vacancy with someone else.  If a practice manager has had the pleasure of recently filling a coding or billing vacancy, he or she should understand the importance of bringing in another one who is ready to help out throughout the organization and grow into one of those roles.


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## WilloKeays (Oct 3, 2012)

I have 15 years experience in marketing.  My last position was as Director of Marketing and Membership.   Granted I took several years off from my career to care for my husband who passed away from cancer - and then my parents who too are battling cancer.  I went back to school for an AS Degree in Medical Information Billing & Coding - on top of my BA Degree in Communication.  I passed the CPC exam the first time I took it.

I've sent out 150 resumes since May.  I still do not have a position because I do not have experience in the medical field.  That is the reality of the job market now.


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## Pam Brooks (Oct 4, 2012)

WilloKeays said:


> I have 15 years experience in marketing. My last position was as Director of Marketing and Membership. Granted I took several years off from my career to care for my husband who passed away from cancer - and then my parents who too are battling cancer. I went back to school for an AS Degree in Medical Information Billing & Coding - on top of my BA Degree in Communication. I passed the CPC exam the first time I took it.
> 
> I've sent out 150 resumes since May. I still do not have a position because I do not have experience in the medical field. That is the reality of the job market now.


 

I'm sorry you're having difficulty finding work in the coding field, and your frustration is very clearly communicated in your post. We all have personal issues that we've dealt with that have taken us away from our career goals, myself included, although I won't go into detail.   I do not consider myself out of touch with the reality of the job market, and I pride myself on being one of the very few employers in my area who actually hires coding assistants without any experience. The new coders I hire are typically second-career folks, with absolutely no healthcare experience, other than a coding course and a CPC-A.  I find that it's easier to train new coders than it is to break bad habits!   Unfortunately not all hiring managers feel the same way I do.  
Are you sending out the same resume to every job posting?  You might try to tweak your resume to highlight the skills you have that are required for each position you apply for.  Also, look at the language of the job description, and try to incorporate those phrases in your resume or cover letter.  It shows that your experience mirrors their needs.  Have you been on interviews?  If so, you might want to get back to the interviewer and ask them to give you feedback about why you weren't given the job.  "Not enough experience" is the politically correct way to turn people down.  Feedback can be valuable, although sometimes hard to hear. Hopefully you can gain some insight as to what you can do to secure the next job you apply for.  Good luck!


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