Top 10 Cringe-Worthy Things Wannabe Coders Say

My blog is over six years old!  Seriously, I just checked.  In the last six years as I've put myself out there as the Coder Coach, I've spoken either personally, over the phone, or via email to hundreds - okay, it's really probably dozens - of coders and tried to answer their questions about what it takes to be a coder.  I've been amazed at how those answers have changed since then, from the evolution of technology, which allows most coders to work remotely to finally seeing ICD-10 come to fruition. So I figure it's about time I published my top 10 list: the most cringe-worthy things people say when they tell me they want to be a coder.

Don't get me wrong.  My intent is not to put anyone off, but over the last six years, this coding thing has really caught on and I wouldn't want to steer anyone into a career that isn't right for them.  So take a moment to read through the list and decide if you're guilty of any of these. Since David Letterman's Late Show is no longer a thing, consider this my replacement Top Ten List.

And before you get upset, please read the sign: I'm not arguing, I'm just explaining why I'm right.  In other words, I'm being a coder (occupational hazard).

Number 10:Which type of coder pays the most?

Answer:  A really good one.  Focus your efforts on landing a job and then mastering it.  If you choose your work setting solely for making money, you may find yourself miserable and (maybe) sort of well off.  If you choose to follow your passion, the possibilities - and pay check - are pretty much endless.  Employers are willing to pay good money for really good coders who don't complain about how much they hate their jobs.  I don't actually do any hiring, but if I did, I would hire the hungry novice coder with a good attitude and a willingness to learn over the experienced grouchy coder who seems to hate her job.

Number 9: Should I be a hospital or physician coder?

Have you ever seen the movie City Slickers?  The answer is in that movie when Jack Palance says the meaning to life is "one thing."  Billy Crystal asks him, with great interest, what that one thing is.  The answer: that's what you've gotta figure out.  You and only you can decide which setting is right for you and there is no right or wrong answer.  I love getting an inpatient hospital chart and trying to figure out the latest surgical procedures and how to code them.  I would rather poke my eyes out with a dull pencil than assign an E/M level to a physician's chart.  I know other coders who love E/M coding.  It's like being a cat person or a dog person.  You will probably find that you like one more than the other and there is no wrong answer (unless you are not a cat person, and then we can't be friends anymore).

Number 8: No one will hire me with the coding credential I have; they all want something else

This is probably going to sting a bit, so brace yourself.  Why did you pay to get credential without first looking at local job postings and doing some research?  If you are reading this before going to school or getting certified, then do your homework before you pay any money to any educational institution.  All kinds of people will tell you anything to get your money.  Only local employers will be honest about what credentials they want.

Number 7: Where can I get free continuing education credits?

Free CEUs are out there, you just have to look for them.  Most AAPC local chapters offer free monthly educational sessions.  There are opportunities to summarize articles and get credit.  Coding Clinic offers a quarterly webinar that is free.  Other organizations offer free CEU credits.  Do an internet search and you may be surprised what you will find.  Did you do something, like attend grand rounds at a hospital, that you thought was very educational but you don't have a certificate?  Contact the certifying body and see if they will grant you CEUs for it.

Number 6: I can't afford to join AHIMA or AAPC

This one might sting too.  Find a way to make it happen.  As far as I'm concerned, when I hear this, it tells me you don't want it bad enough.  Granted, I started very young and was still living at home when I first joined AHIMA, but make no mistake, I worked hard to get where I am today. Find a way to afford that membership and show people you are serious about a coding career.  And if you have a credential through and let your membership lapse, you likely lose the credential.  You worked hard for that credential - don't let it go.

Number 5: This is my second (or third) career; I can't afford to start at the bottom

This is a great second or third career for people who discover they missed their passion until later in life.  But here's the reality: you still likely have to start at the bottom.  I've seen people find their way into coding by some very unusual means, but the ones who make it are the tenacious ones who won't take no for an answer.  Pretty much no one starts out in their dream coding job.  You will have to pay your dues.  And please don't think that means  I can't appreciate your experience in your previous profession.  There are definitely things you can bring to the table, but remember that in coding, you are a novice.  I'm a great coder, but I'm pretty sure if I decided to change careers tomorrow and become an aerospace engineer, there would be a bit of a learning curve. 

Number 4: Will you mentor me?

It's an innocent question and I'm flattered.  Really.  But I decided a long time ago that I would mentor from afar by penning this blog.  I don't have a consistent schedule to be able to spend a lot of quality one-on-one time mentoring.  But if you email me a specific question, I will do my best to answer it.  My advice is to find someone local to mentor you.  Ask them if they can meet you once a month for lunch and come prepared.  What are the questions you want answers to?  What challenges have they had in their career that they wish someone would have told them when they were getting started?  This is a great entry into your local coding network.

Number 3: I went to school for (fill in the blank) months/years and I'm certified; I'm qualified to be a coder anywhere

No.  You're really not.  I went to school too for two years and let me just tell you that even though I learned some good fundamentals, the real coding world is nothing like I thought it would be.  I learned everything I really needed to know about being a coder on the job, not in school.  I've now been coding for more than 20 years and I hold four different certifications and I have a news flash for you: I am not qualified to code anywhere.  I lack the practical experience of a physician office coder.  I find coding radiation oncology charts waaaaaayyyy outside my comfort zone.  And please don't ask me to fill out an IRF-PAI for inpatient rehabilitation.  In other words, after 20 years, I am not all that and a bag of chips, so please don't insult the world of experienced coders by thinking you have this all figured out.  I learn something new each. and. every. day.  Keep an open mind and be willing to learn - and admit when you're in over your head.  Natural curiosity and a willingness to learn is a good thing.  Acting too big for your britches is not.

Number 2: How can I get experience if no one will hire an inexperienced coder?

I would give anything if people would stop asking me this question.  Because honestly, I don't know the answer.  I don't know what your background is.  I don't know what your aptitude for coding is - and it is a skill that many people don't possess.  I don't know where you've applied or how hard you've tried to sell yourself.  And probably most importantly, I don't have a clue what it's like to try to get a job today because the atmosphere is so different from 20 years ago.  But this is what I do know.  Don't limit yourself to coding jobs.  Find a job - any job - that will require you to have coding knowledge.  When you do an online job search, search on the code sets (ICD-10 or CPT) and not the word coder.  There are so many jobs out there that revolve around coding that aren't traditional coding jobs.  Getting your foot in the door is one step closer to getting that traditional coding job - or something even better than you ever imagined.  And don't forget to network.  If you want to work with coders, surround yourself with coders.  Who you know may be your golden ticket.

And the Number 1 Cringe-Worthy Thing Wannabe Coders Say is: I want to be a coder because I want to work from home

AACK!!!!  Not a good lead in!  And if this is the first statement out of your mouth when you go into an interview, you probably won't get hired because here's a huge industry secret: hiring managers hate hearing that's why you're there.  It's like going on a first date with someone you just met and gushing about how badly you want to get married and have 6 kids. It's just not done.  If this is the real reason you want to be a coder, please re-evaluate.  Coding is a great career if you love it.  If you don't love it, you will be miserable for 8 hours every day.  And if you are miserable at home for 8 hours a day, that can be really depressing.  Also think about the child care aspect.  I often hear people say they want to work from home because they can't afford child care.  Many coding contracts require you to have child care in place.  Coding takes intense concentration and you can't babysit a kid at the same time.  Working from home is a great perk, I will admit, but it is not the reason I have the job I have.  I refer you back to Number 10 above: follow your passion.  If you're lucky, you can make some good money while you do what you love... from home... in your bathrobe.

Article Review: The Coder Coach Responds to "Industry Disconnect"

I'm afraid today's topic won't be quite the entertainment fodder that many of my readers have come to enjoy because this is a serious topic and one that I am very passionate about. And it deserves a serious blog posting!  Someone recently asked me on my Facebook page what I thought about a recent cover story published in For the Record Magazine.  "Industry Disconnect" by Selena Chavis is a great read for anyone who has been pounding the pavement looking for a coding job.  It is also a must read for any coding professional with hiring power.  In short, this article highlights the biggest threat to the future of the coding industry: the ability to hire, mentor, and train recent grads.

It's no secret how I feel about mentoring our future workforce.  My thoughts are well documented throughout the Coder Coach and my colleagues in the state of Colorado know how outspoken I am about the topic of mentoring coders.

So when I was asked, I thought, wow, what a great topic for my blog.  Here are my thoughts on the article: it illustrates an accurate, although bleak, outlook on the future.  But all is not hopeless.  This article has some great points, but it also brought to mind some myths about coding mentoring and training that I would like to address.

Myth 1: There is a disconnect between coding schools and employers and no one cares or is doing anything about it
Partially true.  In general there is a disconnect between schools and employers, as documented in the article.  It is not true that no one cares.  Hello!  Are you reading my blog?  I currently sit on Colorado Health Information Management's Student Alliance Task Force - a mouthful, I know!  This is an alliance made up of CHIMA members and directors from the local HIM schools and we spend our time trying to figure out how to get better and more meaningful internship experiences for students.  There are a ton of road blocks and we are trying to decide how to break them down.  More on that in a sec.

Myth 2: Hospitals will only hire people who can hit the ground running
I hate this myth.  Because, in my experience, there is no such thing as a coder who can hit the ground running.  Okay, that was deep.  Let me repeat with more emphasis,  there is no such thing as a coder who can hit the ground running.  It's true that new grads take more time and as the article mentioned, there is only so much you can teach in a 2-year program that will prepare people for a future in electronic medical records, privacy and security, coding, cancer registry, and the list goes on.  It is unrealistic to expect new coders to be able to hit the ground running and it's ridiculous to exclude new grads thinking they won't have anything to offer.  I have never hired a coder - novice or experienced - who didn't need on the job training.  It's true that you can teach an old dog new tricks, but it's equally true that old habits die hard.  A new coder may not have experience, but as Linda Donahue, RHIT, CCS, CCS-P, CPC mentioned in the article, it is easier to teach new habits than correct old ones.  If you can absorb information like a sponge, you may have a serious future in coding.

On a side note, I decided to test this no-such-thing-as-hit-the-ground-running theory, so I called up my friend and newest coworker, Sandy Giangreco, RHIT, CCS, RCC, CPC-I, PCS, COBGC, CPC, CPC-H and AHIMA-Approved ICD-10-CM/PCS Trainer (are you getting the impression that Sandy has a little experience?!).  I asked her if she felt like she'd hit the ground running and she said sort of.  Now keep in mind that Sandy has many years of excellent coding experience (and a couple certifications!) and was hired by Haugen Consulting Group as a Senior Consultant.  We don't have to teach her how to code.  But she is trying to get used to our way of doing things and our training materials so that she can further develop more materials and peer review other content.  She is not up to speed yet.  But it's only like her second week, so I'll cut her some slack!

Myth 3: If hospitals take the time to train people, they will just leave and take those skills elsewhere
Oh waaaa.  Oops, did I type that out loud?   This is something that industry leaders need to get over.  We no longer live in an era where people pledge allegiance to a certain company and stay there for 30 years and retire to a blissful lifestyle at the age of 62.  When I got my first coding job, my manager and mentor, Lila, told me she knew she wouldn't be able to keep me but she wanted to give me an opportunity.  And I am so thankful she did.  There are other Lila's out there who are willing to train you so they can have a hand in training the future workforce as a whole - not just at their own institution.  I think if more people adopted this mentality, the future of the coding field would be bright indeed.

Myth 4: No one is willing to train on the job
So it turns out Lila was right.  I worked for her for three years before taking a job as her peer coding supervisor at a sister hospital.  And then she moved on for another career opportunity outside our hospital system.  That was 15 years ago.  Recently our paths crossed again when Lila took a management position with one of my clients.  Last fall I got to travel with her during a training trip and it was so much fun to be back in the company of that person who first gave me a start.  And I was dying to ask her: if you could do it all over again, in today's climate of EMRs and code-based reimbursement, would you hire a green coder like I was back in the day?  And she said yes.  Here it is almost 20 years since she gave me a chance and so much has changed with coding and HIM and she still feels the same way about training and mentoring.  God bless Lila and every coding manager like her.  We also have a hospital system in Colorado that recently opened their own coding school in preparation for ICD-10 and they are accepting people with baseline coding class experience and placing them into coding positions at the end.  People are willing to train, you just have to find them.

Myth 5: Experienced coders know more
Okay, so this may be where I lose some loyal blog readers and for that I apologize.  I will start by saying that I know some really smart, terrific coders who can code like nobody's business.  And as a coding trainer, I also know a lot of "experienced" coders who don't know as much as they think they do.  At Haugen Consulting Group, we actually have a training program for experienced coders about coding basics or fundamentals where we get them back to the coding guidelines.  Because they forget.  They get so caught up in the details that they can't see the forest between the trees.  And it's not really their fault.  My point is, new coders may have an advantage here - we are trying to get coders back to the guidelines and most students know nothing but those guidelines.  They are also "closer to the books" when it comes to things like anatomy and physiology.  And I cannot stress enough How.  Very.  Important. This. Will.  Be. For. ICD-10.  No coder knows everything - it's impossible.  I learn more about coding every day and I teach the darn stuff.  That's actually what I love about it.

Myth 6: Coding students can't get hands-on experience because of EMRs
There is some truth to this.  I hate that word "can't," though.  When I did my internship I reported to the hospital every day for 3 weeks like it was my job.  There was a coding unit and all the coders sat together.  I understand that that hospital no longer has a coding unit.  The coders all work from home by accessing the electronic medical record (EMR).  And that's how most hospitals are these days.  It's not impossible for students to get hands on experience, but it is challenging.  The main road block here is HIPAA.  The Health Insurance Portability and Accountability Act of 1996 allows for electronic submission of health information and as HIM professionals, we understand the confidentiality and security issues surrounding protected health information (PHI).  As HIM professionals, we have a duty to keep this data confidential but we also have the duty to train new professionals.  We are trying to find ways to bust this excuse, but our first commitment is to the patient and protecting their data.  That's just something to think about when you complain about the background check you need to go through to get access to a system as a student.  How would you feel if it was your medical record?

Myth 7: There are not enough coding jobs for students
Bologna.  I've said it before and I'll say it again.  There may not be a bunch of jobs for "coder," but there are tons of jobs that are coding related.  Stop searching for coding positions in HIM departments and ending your search there.  Start looking for jobs that have ICD-9-CM and CPT embedded in their job descriptions.  You will learn more than you think just by being around codes.  Plus, if you can get a job in billing, this is a great place to see coding reimbursement in action.

Wow, this is already way longer than I intended, so I will leave you with this.  I love that Ms. Chavis's article was the cover story.  I think this is the most critical issue facing our industry today (even more so that ICD-10!). But I don't want you to walk away from this article thinking that a future in coding is futile.  Get out there and network!  People give jobs to people they know, so go out there and get known!

If you haven't found a job in coding, ask yourself if you've exhausted every option.  I meet all kinds of people who want to be coders for all kinds of different reasons.  If you want to be a coder only because you want to work from home, stop now.  You won't be successful.  But if you want to be a coder because you love the detective work you have to do to pull documentation together to get those codes, then there should be nothing on this earth that will stop you.  I see a lot of people making excuses about why they aren't getting coding jobs, but I firmly believe that if you want it badly enough, you will get there.  I'm no stranger to excuses myself - mostly when it comes to living a healthy lifestyle.  So lately, I've been carrying around this quote as a reminder any time I catch myself making an excuse and falling into the role of victim:

"Ninety-nine percent of the failures come from people who have the habit of making excuses."
-George Washington Carver

I am willing to work with my colleagues to remove the excuses about why we can't train and mentor.  Are you willing remove excuses for any of your own roadblocks that you've put up?

Now Blogging in Two Places!

If you haven't had the chance to check out AHIMA's HI Careers website yet, you definitely should. Besides all the great information for HIM and coding job seekers, they've recently added a series of blogs from industry pros - including yours truly. I will continue with my Coder Coach blog as well - now you just get to read me in two places! Plus, you get the added benefit of hearing from others as we tackle some FAQs about getting hired in HIM.

AHIMA's HI Careers website

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.

Could More Job Openings be on the Way?

Here's another interesting article - this time from the Wall Street Journal - about the increasing rate of people leaving their jobs. With other job options for experienced workers and the recession on the upswing, people are feeling more comfortable abandoning jobs for happier times. While this may mean they are leaving positions in less than favorable working conditions, it could potentially leave employers open to hiring and training inexperienced people. So I ask you one question: Are you willing to work somewhere that has employee morale issues just to get experience?

I will let you ponder that while you click this link to the article: More Workers Start to Quit.

10 Best Cities for the Next Decade

I always like to pass along any links I can find about getting jobs. While this article is not specifically about coding jobs, it does list 10 cities that could prove to be hot spots for more jobs in the future. And when more jobs are created, that means more people. And people need health care. And all the health care claims they generate need to be coded and billed. See where I'm going here?

If you took the time to research the job market before you enrolled in coding classes, you should have a good idea of what's out there. If not, I encourage you to look into relocation to get a job. I know a lot of people are rooted in their communities and either can't or don't want to move, but if it means getting your foot in the door, it could be a necessary evil.

Enjoy this article from Yahoo Real Estate: 10 Best Cities for the Next Decade.

Code Words for Getting Your Foot in the Door

It's the question I am asked most often as a mentor. "How do I get experience if no one will hire me without experience?" The unfortunate reality is that many employers aren't ready to assume the time, effort, and risk associated with hiring a newbie coder. But that doesn't mean that getting a job as a coder is impossible.

If you begin by looking at the job postings in your area for coders and then take a look around your live or virtual classroom at the number of students who will be looking for coding positions at the same time you will be, you can see that it just doesn't add up. In most markets there simply aren't enough coding positions for every coding student. But that doesn't mean there aren't other positions that will allow you to use and cultivate your skills and potentially align you for that coding position.

It can be especially tricky to make your way into a coding position in a hospital if you have no practical experience. The reasons for this are varied: some hospitals don't hire "newbie" coders, some hospitals have so many coding positions open that there are limited entry-level positions available, and some hospitals receive many resumes from both experienced and novice coders and subsequently hire the experienced coders. But this doesn't mean that the door is permanently closed - you just need to know how to nudge it open.

Consider HIM Positions
In the hospital setting, coding is often part of the health information management (HIM) department. While it can be difficult to get a coding position right out of school, it might be easier to get an entry-level position into an HIM department. This may mean assembling or scanning medical record documents, analyzing medical records for missing documentation, abstracting data for core measures and other hospital reporting needs, birth certificate completion, transcribing medical record reports, and working with registries (e.g., cancer, trauma, cardiac).

Many HIM departments promote coders from within when they show promise. Once you have your foot in the HIM department and are working solidly within one of these non-coding positions, though, it is no time to get lazy. Offering to do projects and work on teams that will expose you to coding and coded data is crucial. If you are interested in a coding position, you should never be shy about letting your supervisor know that that is your goal. If a coding position opens up, you need to make sure that HIM and coding management are aware of your interest.

The bonus to a position within HIM is that should a coding position become available, you will already be working for the managers responsible for hiring. You may also be exposed to other areas of health information and data management that you may otherwise miss if you follow the coding track only. The downside to a non-coding position within HIM is that you may still be overlooked for advancement to a coding position if an experienced, qualified external candidate applies for a coding job at your hospital. The dynamics of internal vs. external hires is very organization-specific, though, and there are always exceptions to the rule.

Try Billing On For Size
If you are interested in the billing side of coding, there may be opportunities in the billing (or patient financial services) department within a hospital. Look for positions that require coding skill by reading through the necessary skills. Dead giveaways include positions that require ICD-9-CM or CPT/HCPCS coding experience or "familiarity." Positions requiring "familiarity" with coding typically translate to entry-level positions. This may include working billing edit reports, processing insurance claims, or following up on insurance claim denials.

The benefits of working the billing end of coding are that you will become very familiar with the edit process and what won't be paid based on codes. This could potentially move into other billing-related positions including charge master maintenance. A disadvantage of working in billing is that should you be seeking a position as a coder within HIM, you won't be working for HIM's hiring managers and it could be more difficult to get the position you ultimately desire.

Develop a Plan
Whichever path you decide to explore, you should always take the time to develop a planned career path - even if that path deviates from your career map. Employers want to know what kind of position you are interested in so that they can assess your skill, how to get you where you want to go, and ensure that your career goals are in line with the organization. So take the time to develop a simply laid-out map of where you plan to be professionally within 1, 5, and 10 years.

Whatever path you decide to take, follow it with confidence and commit to learning as much as you possibly can in that position. It will take time to become skilled as a coder and like to many other worthwhile careers, you will get out of it what you put into it. Best of luck to you all!

Coding as a Second (or Third) Career

I am part of a select group of coding professionals who have chosen coding as a first career. In my graduating class, I was the only "traditional" college student - starting an HIM program right out of high school. The others in my class were stay-at-home moms returning to the workforce or people looking for a change in career. Today I see more and more people seeking a second (or third) career and choosing coding.

Over the last year I've watched my father look for a new job after giving 35 years as a machinist to a manufacturing company. Last year, his company moved operations out of the country and laid off hundreds. And as he goes on interview after interview, it's unfortunate to see that his 35 years of experience is not seen as an asset, but rather as a method to "do the math" and see when he might be ready for retirement.

I am happy to report that my father was recently offered a job and starts next week. We all have our fingers crossed that this will be the good fit he's been looking for. But for the rest of the "mature" job seeking population out there, I recently came across a blog with some good advice. So if you are over 40 and looking for employment, check out this link: Interns Over 40.

Beyond the Books - and Social Networking

Last month I attended the AHIMA conference in Grapevine, TX. One of my favorite things to do at the conference is to attend the exhibits - not because I really want to buy something from every vendor, but because I find it's the best place to network and catch up on the industry's latest trends. This year, I focused on some key areas - mainly ICD-10 (for work) and education (for me and for all of you).

In talking to some of the schools represented at the exhibits, I realized a lot has changed since I graduated and took my RHIT exam. Of course, I already knew this, but I never really thought about how different it is to network into a new position in this new educational system. As students seek out more online education opportunities and medical records move to an electronic format, schools are able to set up virtual labs to closely mimic the real world. The unfortunate drawback to this is that as a society, we've become so "virtual" that employers are seeing an increasing need for soft skills, or those social skills associated with a person's emotional intelligence quotient (EQ).

Soft skills include things like verbal and written communication, the ability to work in teams, motivation, conflict resolution, and leadership. I am neither qualified nor interested in writing a blog about the importance of EQ, but I thought I would present my opinion on the subject and include a few tips - things to think about before going for an interview - that might give you an edge in getting noticed and getting hired.

What WALL-E Has to Say About EQ

In thinking about soft skills and EQ, I am reminded of the movie WALL-E, which, although a kids movie, has some very poignant messages for adults. If you haven't seen the movie, I highly recommend it. The part relating to EQ is the human part of the story where the humans have been living for over 200 years on a spaceship. When we first see the humans, they are riding around in hovercraft equipped with laptops with messaging capabilities and they are glued to their computer screens. They communicate through their computers and ignore everything else around them. It's not until the robot WALL-E accidentally knocks a man and a woman out of their hovercraft that the humans begin to realize they can converse face-to-face.

Now I'm not saying we live in a WALL-E world, but there are days when I think we are headed in that direction. I work remotely 50-75% of the time and most of my work is done using the computer, internet, and phones. This makes it possible for me to work for a client in another state without the expense (or frustration) of airline travel. This is a great thing but the other 25-50% of the time I am face-to-face with clients, colleagues, and students and I firmly believe that no matter how I present myself online or over the phone, what matters most is how I interact in person. Even if you want to work from home, chances are you will need to interview in person, or even via web cam. So how you convey yourself in that initial meeting matters.

Get Off Social Networking Sites and Go Meet People

Social networking is the latest in personal, business, and marketing communications. Facebook, LinkedIn, and Twitter are heavily populated by people wishing to connect or reconnect and I'm all for that (find me at the Coder Coach on Facebook!). But social networking is only one tool and you need to get out and meet people. So if you are planning to get a job in the industry, you need to meet people face-to-face. Look for local seminars and AHIMA/AAPC chapter meetings where you can meet other coding professionals. I am much more likely to recommend and endorse someone I've met personally versus someone I've met online.

But meeting industry professionals is going to be tough. As mentioned, today's technology lends itself to remote work and more and more coders are working from home. In addition, hospital budget constraints often mean coders must pay for their own continuing education and either take paid leave or no pay to attend classes. As an alternative, many coders are opting for distance education in the form of online courses, audio conferences, and webinars. This means less of a networking pool for novice coders. So seize every opportunity you can to network in person with coding professionals. Check out your local AHIMA or AAPC chapters to find something close to home. If all else fails, find a local mentor and meet with them on occasion. Once you meet one person and they start to introduce you around, you will be amazed at how quickly your non-virtual network grows.

Looks Matter

We're all told that we need to look at people for who they are rather than how they look. Well, in business, how you look matters. I am not saying everyone needs to go out and get plastic surgery, but here are some tips:

1. Dress for the job you want. I think we've all heard this one before and it's true. Look at people who are in the industry in the positions you someday hope to hold and emulate their dress patterns. This is true even during networking events, such as seminars, meetings, and educational events (other than traditional classroom education). Pay attention to conference brochures - they usually tell you what is appropriate (business, business casual, or casual). If you are networking with potential employers, I always recommend either business or business casual, but never casual. You want to send a message to employers that you are serious about your career.

2. Observe standard corporate business attire - unless given permission to relax the rules. I realize this is the 21st century, but there are still some old fashioned rules that may never go out of style. You can google "proper business attire" and get a million hits on what to wear. Here is my personal take on it. For women, skirts should be no more than 2-3 inches above the knee and leg coverings are recommended (at least for the first meeting). Dress slacks are fine, but foot coverings should be worn (again, at least for the first meeting). Don't wear cropped or capri pants - even if they are dressy - for interviews. Some places may accept them, but not others and you want foolproof attire on the day of an interview. Avoid jeans, t-shirts with printed letters or logos, tank top, sleeveless tops, halter tops, short skirts, sandals, tennis shoes, or shorts. For men, business attire generally includes slacks with a button down shirt that can be worn with or without a tie or jacket depending on the formality of the setting. Men should avoid jeans, khakis and polo shirts (unless business casual dress is called for), t-shirts, tennis shoes, and sandals.

3. Ignore what everyone else is wearing (except for your mentor whose job you someday hope to hold!) and dress for the occasion. When you are looking for a job you want to stand out from the crowd (in a good way!). Now is not the time to be pressured into sloppy dressing by your peers.

4. Remove additional piercings and cover tattoos. A former coworker comes to mind here. As a traveling consultant, it's always interesting to see your coworkers dressed down during non-business hours. Many days a team of consultants looks like a group of agents from the movie Men in Black with conservative black business suits. So imagine my surprise to see one such male consultant sporting an earring at the airport. Maybe there were tattoos too, but I never saw them. The point is - business is still conservative. It's okay to have the tattoos and piercings, but portray a more conservative image when you are meeting a business contact for the first time.

5. Tone down hairstyles, makeup, and accessories. I love movie references, so here's another - think about the movie Working Girl where Melanie Griffith's character starts out with huge 80s hair, loud makeup, and over-sized accessories and ends up with smart business suits with subtle accessories (and Harrison Ford!). I admit, this is a hard one for me because I love accessories, but I try to wear one statement piece and tone down everything else. If you have color in your hair that is not normally found in nature (e.g., pink, purple), think about styling it in a way that the color is not so noticeable.

6. Don't wear cologne or perfume. You might think you smell nice and maybe other people do too, but particularly in health care institutions, people have allergies. You don't want to offend your future employer by making him/her sneeze. Many hospitals and doctor's offices have a no perfume/cologne rule for the sake of workers and patients. So save your best fragrance for a night out.

How You Write Matters

I am going to try to be very careful here and not get on my soapbox, but I will say this: I am appalled at where we are with written communications these days. I'm all for texting and instant messaging and "LOL-ing" but there is a time and a place and text lingo doesn't apply in business when you are trying to get hired. If you are emailing potential employers, ensure that your communications are professional and contain no typos. If your email has a spell check option, use it, and always read your emails through before hitting send even if you use spell check. After all, "form" and "from" are both words in the English language, but they cannot be used interchangeably in a sentence.

Your resume should also be text-lingo and typo free. I fully admit that I have set resumes aside, even if the candidate is seemingly qualified, because of the typos. I have a natural tendency to edit, so if I get out my red pen just to read a resume, then I am too distracted by the typos to read for content. So write your resume and read it over several times. Better yet - give it to a friend to read to make sure you didn't miss anything. You don't want to be set aside because of a poorly written resume.

People Talk

I really hate cliches, but they're cliches for a reason: they bear repeating. Case in point: don't say anything you wouldn't want printed on the front page of the newspaper. The coding industry is small. This is an excellent networking tool because you can generally get introduced to just about anyone in the coding industry through someone you already know. The downside to this is that people talk. And you don't want them talking about you negatively, so be careful what you say about others in the industry and to whom.

I once interviewed someone who didn't work out and later heard her bad-mouthing me at a conference. Needless to say, I never will hire her in the future. We all have those people who grate on our nerves and we work with people whose personalities just clash with out own. My best advice here is to maintain professional interactions when necessary and never say a negative thing about that person to anyone. The type of reputation you have is up to you. You can be the hardworking team player or the trouble maker.

Want More?

There are a lot of websites and blogs out there dedicated to getting hired and standing out. So rather than rehashing all of those, if you want more information, I listed some links below that might be of interest to you. And since I am such a movie buff, let me offer another recommendation: The Secret of my Success starring Michael J Fox (1987). I love his enthusiasm as a recent grad trying to make it big in business in New York. Most of all, he has such faith in himself and it drives him (unconventionally) to great things. At least you'll get a good laugh out of it (I hope!)

-Personal Branding: 5 Questions to Ask Yourself
-Proper Business Attire:

Research the Industry

A lot of schools will tell you all about their coding programs, but what they may not tell you is what the local job market looks like. And as more and more distance education schools pop up, it becomes your responsibility to find out if there is a need for coders in your area. While it is true that there is a national coder shortage, there is no guarantee that coders are needed in the geographic location where you currently reside. So how badly do you want to be a coder? Are you willing to move somewhere else if there aren’t positions close to you?

Where the Job Postings Are

The initial research is simple. Check local and national job postings. This may mean going to a variety of sources, such as the local newspaper, AHIMA, AAPC, and employer job listings. Don’t expect to find a whole lot in the newspaper ads (although smaller physician practices still use newspapers to post positions), since there are many professional job listing sites and coding positions are highly technical; therefore, most employers go with the professional job listings. Some employers may not have an advertising budget, so I always recommend that you hit their job listings on their websites. For example, if you live within 20 miles of 5 hospitals, check the job listings at all five. And don’t stop there. If you are a member of AHIMA or the AAPC (or both) check their job postings for your area. Look at the national postings if you are able to travel. And also don’t forget to check job postings in industry publications (see my previous post titled “What Should you be Reading?” for details).

Pay Attention to Job Requirements

Everyone wants experienced coders, that’s a given. But they don’t always find them, so don’t stop reading once you’ve seen they are asking for someone with 2-3 years of previous experience. The important thing to note within the job requirements is this: which credentials are they looking for? If you are not certified, this will give you an idea of which credentials are in demand for the employer you want to work for. It will also clue you in to the current job market and you will know if there is more of a need for physician or hospital coders, inpatient or outpatient coders, or even if there are some nontraditional coding positions. Look for those “code” acronyms (pun intended!): ICD-9-CM, CPT, HCPCS. If the requirements to land the position include an understanding of one or more of those, then it’s a coding-related position. And even if you can’t be a “traditional” coder, being in a coding-related position is a start.

Network

I’m sure I’m starting to sound like a broken record about now, but I can’t stress this enough. I have known a fair share of people who were hired because they were in contact with someone who was hiring. This remains important throughout your career. This is a small industry and you will find that you continually cross paths with the same people and as you advance, you may find that employers are courting you. But until the day your name is on the tip of every hiring manager’s tongue, focus on getting your resume straight to the hiring manager and you will be more likely to get an interview or test for the position.

Know Your Stuff

Knowing people is one thing, but I personally don’t endorse or hire anyone until I can vouch for their coding abilities. I’ve never hired anyone without issuing my own coding test, so be prepared to be asked to take one. Being a novice coder is okay and a good coding test will test your skill at any level, but you do need to know at least something about coding. If you don’t know how to locate codes in the ICD-9-CM and CPT codebooks or medical terminology, it’s going to be a short interview. So make sure you at least know the basics before going in. You can further prep by attending local educational seminars and reading trade magazines, which will help educate you and introduce you to industry lingo (and there’s a lot of it). I’m sure this makes little sense right now, but the more you know as a novice, the better off you are (again, please see my post on what you should be reading). My next post will help make this clearer. After all, coding is more than just looking up a code as if it were a word in the dictionary. Stay tuned…