I went to school to become a medical assistant in the early 1990's. This was after already having worked for several years in an unrelated field. I found out I wasn't crazy about the idea of touching people, so I switched my degree to Medical Office Management. I landed a job as a front desk person at a mental health clinic. They taught me to do billing and collections. Then I moved to another mental health practice where I was the manager, and I did all the revenue functions: intake, scheduling, billing, accounts receivable, payroll, marketing, etc. From there, I took a (deserved) break and worked for a year with a stockbroker.
I took a temporary job as a biller with the hospital I work for now, working as a payment poster for a few weeks until I was hired permanently. From there, I was able to move into coding, when an opening became available. I obtained my CPC, and after coding primary care for about 2 years, I was asked to set up a charge capture/coding program for our hospitalist department, and when the group of coders grew to the point where they needed a manager, I was tapped. This was after working 13 years in the field.
So, it didn't happen overnight, but up until the mid-90's nobody even knew what coders were, so it never occurred to me back then to become one!