Persistance!!
Persistance...this is the key to landing the position you desire. I am newly certified Dec 2009. Four months prior, I had applied to a clinic coder position online, not yet certified, but I figured why not?
The ad read something like...wanted certified coder with 3-5 years experience. At the time, I was still in school...but applied anyway, wanted to see if there was actually someone looking at these online resumes!!
Three months passed...finished school, and was then performing my externship which I personally "hounded" the office manager, until she finally gave in!! I stopped in to see her 4 times in persuing an externship! During this time, I went online again, and noticed the coding position I had previously applied for had not yet been filled. So, I applied again, still not certified (Nov 2009), this time instead of 3-5 years experience, it read 3 months experience. I was all over it. Found out who was in charge of hiring for this position and literally made a "pest" of myself. Assuring the person in charge, that they would not be sorry for giving me the opportunity to show them what I could do. I have been on the job, just a little over a month, and absolutely loving it. I am now coding for eleven clinics, and limited ER procedures for the docs in my section.
Unless you show unrelentless ambition, you will probably not get hired...take it from a 52 year old man, persistance is the key!!
Good Luck!!