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June 2013

Employment Can Be Elusive for Newcomers
By Lindsey Getz
For The Record
Vol. 25 No. 9 P. 28

After spending 14 years in the occupational therapy field, Lisa Gordon sought a career change for various personal reasons. Knowing she wanted to stay in the medical field, Gordon decided that coding presented a great opportunity. Yet, despite national reports of coding staffing shortages, Gordon says she’s found it terribly difficult to land a hospital-based position.

For The Record spoke to industry experts about Gordon’s situation and the obstacles faced by other coder-hopefuls who are finding there’s a gap between education and actually getting hired.

When Gordon graduated with her occupational therapy assistant credentials, she had an easier time securing a job in her chosen profession. “There’s such a big emphasis on new grads in the therapy world, and there’s a lot of excitement around the newly certified who bring a fresh perspective,” she says. “I remember going to job fairs and seeing a lot of representation for therapy, but I haven’t had that same feeling since switching to the coding world. I haven’t seen that same kind of representation of the HIM world at job fairs.”

Gordon says even entry-level HIM jobs require some experience, resulting in a catch-22. “The biggest frustration I’ve had is repeatedly being told I need more experience but feeling like nobody is willing to take me on and let me learn,” she says. “I’ve been applying at teaching hospitals, hoping they’d give an entry-level person who is eager to learn an opportunity, but I keep hearing I don’t have enough experience. So how do I get that experience if they won’t give me a chance?”

Credentials vs. Experience
Although Gordon boasts the RHIT credential, some experts believe employers are more infatuated with the CCS designation. Gordon plans to obtain the CCS credential but has been frustrated by the educational expenses that are adding up while her uncertainty about landing a job grows. “It’s proving difficult to continually spend the money for more certifications with no guarantee of a job,” she says. “Is the best thing to just get as many certifications as you can in order to better your chances of getting a job in a hospital?”

Industry experts suggest that’s not a bad idea. “The RHIT credential does not primarily focus on coding,” says Jacqueline Thelian, CPC, CPC-I, PMCC, lead instructor at Medco Consultants. “It is typically more of a credential for those who want to go into a management position with medical records. I do find that a lot of the hospital jobs are for certified coders, so going for that credential could make a huge difference.”

However, that takes time and in the here-and-now, Thelian believes that newly certified RHITs such as Gordon would benefit from seeking internships and volunteer opportunities. Spending free time volunteering demonstrates dedication and interest in the field. “Go to the hospital or health care facilities in your area and ask for an appointment with the office or compliance department manager about getting an internship,” she says. “Even a couple hours a week as an extra pair of hands to help out is something that will be looked upon as showing character and helps get your foot in the door.”

Brandy Ziesemer, RHIA, CCS, an ICD-10-CM/PCS trainer and health information program manager/associate professor at Lake-Sumter State College in Leesburg, Florida, says a willingness to begin in a humble position can be a launching pad to greater opportunities. “Take a lower-end position but use it to show off your work ethic and enthusiasm—and definitely don’t complain about being in a lower-end job,” she says. “I’d say that within six months of working in a lower position for a large health information department, an average RHIT with strong coding skills or a CCS is promoted to a coding or analytical position within that organization. It is true that in Florida we have more retirees and therefore more health care facilities per square capita; however, I still believe that using a low-level job as your foot in the door is a good opportunity anywhere.”

Like Thelian, Ziesemer believes volunteering could be beneficial to those struggling to find a job. “You’ll get hands-on experience and also show your enthusiasm for the field,” she says. “Next time they do have an opening, you just may be at the top of their list.”

Neil Stanley, regional president of corporate partnerships at Harrison College in Indiana, believes enlisting the services of a large staffing or recruiting agency may help secure a position. “In this climate, where coders are in high demand, it may be that those who are struggling to find a job are fishing in the wrong pond,” says Stanley, who spearheaded the college’s ICD-10 comprehensive medical coding training curriculum. “If you have already earned credentials, I’d recommend that you connect with a staffing organization or a professional recruiter because there are jobs out there.”

Getting Past Human Resources
Another problem facing job-seeking coders is the gatekeeping process that often takes place at large organizations. “Many applicants get automatic rejections and never get past human resources because their résumé may not match what the job posting says,” Ziesemer says. “But that doesn’t mean those job applicants wouldn’t make good hires. Many of my qualified grads have gotten automatic rejections because their application was automatically filtered out, but when I call the hiring supervisor and explain how they’d make a good candidate, they can often get an interview.”

Ziesemer says human resource departments at many large organizations are swamped with the responsibilities of hiring for every position at an entire health care network. “I’ve been told that when there’s a coding opening, they sometimes get hundreds of applications and many are wild, such as ‘My grandmother was sick and I helped with the insurance paperwork,’” she says. “They have to have a system in place that filters some applications out simply because they don’t have the time to go through them all.”

Sometimes that means candidates who have the credentials—but maybe don’t have a lot of experience—are eliminated before getting a chance to prove themselves. “If you can be tenacious and get to the hiring manager for that department and explain why you’re qualified and how you will work hard, that could help you get an interview without the previous experience,” Ziesemer says. “Even better, if your college program director can send a recommendation, that can help you bypass the experience requirement. Colleges are busy, so do the legwork and gather all the information about the job you’re going for and give that to your college program director so that all they have to do is send a quick note to the hiring supervisor.”

Stay Positive
Gordon has pondered pursuing ICD-10 training, which industry experts say is important for finding a job in today’s market. However, she’s concerned about learning ICD-10 when she doesn’t have much hands-on experience with ICD-9. “Not having experience in ICD-9 is not a deal breaker,” Stanley says. “I’d just encourage her—and others—to seek anatomy and basic terminology prerequisites. Considering this job seeker has a physical therapy background, she probably does have that background already. Should she then complete a course on ICD-10, she’d have enough credentials to be highly considered at a coding organization.”

Although Gordon is beginning to become frustrated, it’s important to understand that starting a coding career is not an overnight process. “I do feel there’s a need out there and it’s not going away anytime soon, but job seekers still need to do some work to land those jobs,” Ziesemer says.

“There’s definitely opportunity out there, but you can’t get discouraged,” adds Thelian. “I tell my students that if 20 doors close in your face, you still need to look for the one that will open. I suggest that those who are new to the industry broaden their search a bit and be willing to step out of their comfort zone. There are opportunities not only in hospitals but in attorney offices, accounting firms, doctor’s offices, long term care, and more. Many of these may be avenues to the job you really want, and you just have to be willing to put the time in somewhere else. You never know where it could lead. Have faith in yourself and refuse to give up.”

Gordon says that despite her struggles, she remains enthusiastic about the coding profession. And her outlook is a bit brighter now that she’s earned a part-time job in the HIM department at a long term care facility. It’s a step in the right direction toward her goal of working in a hospital.

“What I love about the HIM field is that it’s so broad, and you do have opportunities in so many different directions,” she says. “I hope to find a full-time coding position that’s right for me, but in the meantime, I am enjoying learning.”

— Lindsey Getz is a freelance writer based in Royersford, Pennsylvania.