Wednesday, June 30, 2010

Yes, Coding is Hard

I was recently perusing some online message boards and came across several postings with a resounding theme: Is coding really that hard? In a word, yes. If coding was easy, it would be easy to get a job. You wouldn’t need those 2 years of experience just to get your foot in the door. And although I want to maintain a positive can-do attitude to anyone pursuing a career in coding, I sometimes forget to exercise a little tough love and make sure that people understand exactly what they are getting themselves into and what will be expected of them.

First of all, not everyone can be a coder. Yes, there is training involved, but some people, even with years of training, will never be successful coders. So often we hear someone trying out for American Idol who has no business singing in public and we may wonder, “What made him think he could sing?” Well, the same applies to coding, albeit, in a different way. Some people aren’t detail oriented enough or don’t like medical terminology enough or can’t cope with frequent guideline changes from payers. When I hear potential coders complaining about such things, I wonder why they want to be coders.

Secondly, many people enter into coding so they can work from home. When I ask someone why he wants to be a coder and his first words are, “I want to work from home,” I usually probe a little deeper. I want to know how potential coders feel about working long hours in front of a computer with little human interaction. I want to know how well they can concentrate on their work and how detail oriented they are. I want to know if they are willing to put in weeks, months, or even years at a hospital or clinic before being released to work from home. I want to know if they are in love with coding or just the idea of coding.

Being a coder means knowing a lot of medical terminology, anatomy and physiology, disease process, and being able to read a medical record and piece together the patient’s clinical picture and translate them into codes. It’s about “peeling the onion” – that is, consistently learning more and being okay with the fact that you will never know it all. If that doesn’t sound like fun to you then coding isn’t for you.

So if you decided on a career in coding because the pay sounded good or it would allow you to work from home, I ask you to pose some hard questions to yourself. Are you willing to put in the time and effort to get the career you think you want? If you are, then let me be the first to welcome you to a rewarding career in coding. If you’re not, I encourage you to find a career you will be passionate about.

Tuesday, June 29, 2010

Keeping Keepers

When I took my first job as a manager, I received a basket of "necessities" from my coworkers. I can't remember everything that was in the basket - things like Diet Pepsi and Visene and a couple other tongue-in-cheek items poking fun at the challenges of being a manager. The most memorable thing, though, was a simple manilla folder, marked with the label "Keepers." I wasn't sure what it meant and which of my coworkers would put it in there or why.

It was my mentor and first supervisor who told me that it was she who put the keeper folder in the basket and then she proceeded to tell me why. She said as a manager I would be under the microscope and there would be days when all I heard from my employees and coworkers is what I was doing wrong. And because of that harsh reality, it was even more important to maintain a keeper folder in order to keep my confidence up. So as all you novice coders out there try to break into the industry, I encourage you to start a keeper folder as well.

The purpose of the keeper folder is to fill it with notes and emails of compliments from people on things you've done well and received praise for. Think of it as a rainy day folder that you pull out and read on those days when things aren't going well for you and when it seems like you can't do anything right. It's a reminder that there are things you've done so well that someone decided it was worth mentioning it to you.

I honestly can't tell you what happened to that original folder that was given to me so long ago, but every time I start a new job, I almost immediately create a virtual folder and save emails containing compliments and praise from coworkers, clients, and my bosses. Did you receive a good grade on a paper you wrote or get an email from someone thanking you for doing something special? Or did you receive a note from someone with a compliment that came out of left field? Well, start to put them together and organize them - you may find the additional pick-me-ups are a saving grace as you try to land that first job.

Friday, June 18, 2010

How the Coder Coach Spends Her Time

You’ve read the blog postings before – I am very passionate about helping folks break into the industry. And as I step on my soap box to tell novice coders to be persistent and network, someone inevitably asks me if I hire new coders. The honest answer is no, but it’s not because I wouldn’t if I had the opportunity. The truth is, as a consultant, I am working with clients who expect - and pay a premium for - experienced coding knowledge. And because I am not in a position to hire new coders, I write this blog, present monthly Coder Coach events, and tweet relevant articles I come across. When I give that answer, the next inevitable question is, “What do you do as a consultant?” So I thought I would take a moment to tell you what I’ve been up to lately – in my day job.

Because I work for a small company, we get a wide array of requests, so to many, my job may seem like a crazy schizophrenic mess. I can’t possibly put down everything I do without writing a small book! So I decided I would take the last couple of weeks and give you the rundown.

I’ve been working with a client for about a year to improve their coding and charging accuracy in the cardiac cath lab. While that may seem simple and straightforward, the client is a large teaching hospital and training the coders isn’t enough – we also need to talk to the nurses, techs, and doctors about documentation. Last week I traveled to the client and presented seven identical training sessions to the nurses and radiology techs in the cath lab on how to improve their documentation. Each presentation was two hours. And that two hour presentation took about a week to prepare for. In between training sessions, there were meetings with cath lab and HIM management and time spent one-on-one with one of the coders who had questions on some cases. I had an extra treat last week when we were invited into the cath lab to see some procedures being performed.

During the evenings last week I put the final touches on two presentations I needed to submit for this week’s AAPC chapter meeting and also met with my boss about a potential new contract that would significantly impact my summer work deadlines. After traveling home, I attended my first board meeting as a director for the Colorado Health Information Management Association where we planned our strategic initiatives for the coming year and I took a few moments to stress the importance of hiring new pros and expressing a need to get more employers on board (I just want you to know that I’m also preaching to my peers!).

This week my time was split between clients as I prepare for training a client next week on injections and infusion coding and follow-up with my cath lab client on the issues from last week and plan the next round of training. I spent several hours analyzing client data and doing a couple of chart audits. Last night I spoke at the AAPC chapter meeting and networked with some folks a bit. Today I will be pulling together the handouts for the next Coder Coach event and again preparing for next week’s training.

Over the coming weeks and months, I have several training sessions to prepare for with clients, client reports that need to be written, and client meetings that need to take place. I am also working on our company’s plan for ICD-10 training, writing white papers on ICD-10 implementation and training and presentations for two AAPC chapter meetings next month. We don't want to think about it, but fall is right around the corner and it's the busy season for consultants as we study the code changes and read the Federal Register for changes to code-based reimbursement for next year. Amid all of these tasks are a myriad of other little “to dos” and more than one project I’m not yet aware of. In my spare time (?!), I blog, network, and do other miscellaneous things for the Coder Coach group and soon will also be blogging for AHIMA's new HI Careers website.

So if you ever ask me what I do and I pause and say, “Um,” it’s because I’m trying to remember exactly what it was I did that day!

Do You Want to Be a Coding Consultant?

I’ve had a few novices ask me how I like being a consultant. Well, I love it. But it’s not an easy job. And I certainly don’t recommend consulting to anyone until they have several years’ experience under their belts. So if you think you want to travel the nation (or region) or even stick locally consulting clients, make sure you have practical experience first – it’s the absolute best preparation for giving advice to clients.

Let me stress this about consulting – many people want to be consultants because of the salaries. It is true that most consulting firms pay well. But there’s a reason – it’s the price you pay to be away from home so much. If you haven’t seen the movie Up in the Air with George Clooney yet, I highly recommend it to anyone who wants to be a traveling consultant because it is an accurate depiction of what it’s like to be away from home so much. So before you offer to be a consultant, think about what it really means to be away from home 4-6 days per week.

The Coding Career Path

I had my career path all planned out in the 90s. I would be a hospital outpatient coder and then move to inpatient. Then I would become a coding supervisor and then a coding consultant. I hit all those goals by the time I was 27. I didn’t really think beyond that and I certainly didn’t think there would be a time when ADD would over take me and I wouldn’t be able to sit at a desk for 8 hours (or more) and do nothing but code.

Newbies often ask me about the career path for a coder and these days, there are so many options, I can’t think of a clear path. My best recommendation is to get your foot in the door and see what kind of opportunities await you once you’re there because I never would have dreamed I would end up where I am. And if you want to see the country and don’t mind living out of a suitcase for awhile, then by all means, be a consultant!

My First Consulting Life

My first consulting job was exactly what I thought coding consulting was and always would be. I traveled 100% of the time and spent long days as a backlog coder, interim manager, or coding auditor. In that job I learned the difference between giving my opinion versus quoting regulation and how to (most of the time) be objective with my advice. Along with that I learned a lot about traveling – how to pack a suitcase, the most efficient way to get through airport security, and probably my proudest accomplishment – how to find my way in a strange city with a map (this was before GPS really caught on!).

My New Consulting Life

That first consulting job was 7 years, 2 jobs, and about 300,000 airline miles ago. When I landed into a consulting position where I got to do coding education, everything changed. I spent more time working from home (travel was cut to 50%). I won’t bore you with the details of how I got here, I’ll just say it involved thousands of hours of research, writing thousands of pages of coding text books, and writing and presenting hundreds of Power Point presentations in person and over the web. Now I work for a small company where I have a lot of say in the projects I take on and travel only about 25%.

Paving the Way
I looked long and hard to find this job. As a matter of fact, the job didn’t really exist – it was essentially created for me when a friend and former coworker half-jokingly asked me if I wanted to be their ICD-10 trainer. Paving your own way out of the gate is not the norm, but with perseverance, hard work, and passion about your chosen career, it could be a future possibility. When I began my career, I knew I wanted to be a trainer or educator and I made that fact well known to my supervisors over the years and job opportunities have presented themselves based on that passion to teach.

So find what you’re passionate about in the coding field and make it known. It may take time to land that first coding job, but someday, you may be in the driver’s seat and you may be able to design your dream job.

Monday, June 14, 2010

Are You Locked Out of the Building?

I recently threw my grandmother a 90th birthday party celebration. By the end, it was a great party and I think everyone, especially Grandmother, had a great time. But getting there was quite the ordeal. After reserving 6-foot round tables, I was taxed with finding someone to help me haul them. My friend offered an old pick-up truck, but the truck died on the way to the rental place. So we used her minivan and rented rectangular tables instead.

Feeling good about my ability to change plans at the last minute, we arrived at the clubhouse where I proceeded to lock the clubhouse keys, our purses, and cell phones inside while we looked for something to prop the door open. The look of panic on both of our faces was immediate as I unsuccessfully tried to open the door. It was a Saturday and the management office for the clubhouse was surely closed. Luckily I lived close by. Luckily I had a spare key. Luckily I was able to reach someone at the management office. And after about 45 minutes of agonizing uncertainty, the maintenance guy came and unlocked the door for us.

While I was on the phone, my friend was scoping out the building to see if there were any windows ajar and I was trying to think of a convincing argument to tell the police to get me in the building – thankfully it didn’t come to that. I was so glad that when I’d planned the party and preparation time that I’d thought to invite several family members to help and also doubled my estimated setup time. So the setback from my annoying mistake was ultimately only a bump in the road.

Really, it never occurred to me that we would never get in. Somehow I knew we would not only get in the building but there would be enough time to set up and change from my rain-soaked sweat pants into a dress. I knew that even if the day didn’t come off completely as planned that the most important thing was to have a good time with family and friends. And that’s exactly how it came off in the end. My only regret was wasting the time of friends and family as we waited for a key.

What’s my point? My point is persistence. So often I hear people saying they can’t get coding jobs and I’ve heard of many people saying their education was a waste of time and money and they are going to stop applying for coding jobs. If this is you and you’re about to give up, I encourage you to stick it out and try another way of getting into the proverbial building. Whether it means networking with people you’ve never met before or looking for non-traditional coding jobs that still allow you to use the skills you acquired in school, you need to maintain faith that you will get in. If you allow yourself to feel defeated, you will lose the drive to keep going and possibly find your niche.

Thursday, June 10, 2010

Another Article on Worker Confidence

Here is yet another article indicating that worker confidence is increasing. People are confident they will find new jobs and are leaving old ones. Could this mean more available jobs in coding?
More employees jump ship as economy improves