Hello! I'd just like to add my input, which I hope can create some optimism! So I started my career off in Medical Billing working for a small Pulmonary Health practice and I advanced from there. I've learned quickly that it's sometimes about networking and sometimes "thinking out of the box". Not saying that you're not doing this, but this was something I learned and I did not do initially. To be honest, I did not enjoy so much working in the Pulmonary billing practice, but it gave me some experience, which is needed! During my time there, I offered extra areas in which I could be helpful. At that time, we were implementing our new patient portal service for our practice. So I offered my eagerness to help and I ended up taking lead on this initiative. Once we were up and running successfully, I then landed an opportunity working for an insurance company. Many CPC's typically work in hospitals, physician offices, billing companies, etc. Sometimes, we tend to think that these are the only areas our expertise is needed. This is not the case!
I landed a job working as a Medical Adjuster for an auto insurance company. This role involved ensuring medical claims are paid and working with claimants with regard to their injuries. It also involves medical record review, working with special investigations, and many other different areas. So please try searching for coding jobs with auto insurance companies. There's also jobs at attorney offices. I know you mentioned you live in a rural area, so this may be limited. But there's many insurance (auto/health) that hires coders. Life Insurance companies as well. I currently work from home for a Medicaid Health plan, now, so just keep an eye out in this area as well.
Wishing you the best of luck on your future endeavors~
Stephon