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
Friday, July 23, 2010
Thursday, July 22, 2010
Even My Dad's on Facebook - Are You?
Like most people these days, I'm on Facebook. Actually, I maintain a couple of Facebook accounts: one personal and one professional. It's been fun to connect with people from my past and see what they're all up to. And I have to admit, when my brain gets a little fried, it's a quick and simple distraction to see if anyone has posted anything interesting or entertaining. For over a year now, I've tried to convince my parents that they need to get on Facebook so they can reconnect with people from their past. Even so, I was shocked the day I received a friend request from my father.
I'm not one of those people who is afraid to "friend" my parents. They're actually pretty cool and I get along well with them. Plus, I subscribe to the idea that if I'm uncomfortable having my father read it, I shouldn't be posting it on Facebook to begin with. But my dad has only recently become semi-tech savvy. I received my first email from him about a year ago. So getting a Facebook request from him was major. Mom's request came in soon after his and was a little less shocking because she's into gadgets and is one of the few people I actually text.
My point (and I do have one) is this: so many people tell me they don't do Facebook because it's too much work. These people are often people who are looking for jobs. And all I can think of is, if Facebook is too much work and you want to be a coder (and potentially code from home), you are looking into the wrong business.
Let me demonstrate. I have 7 email accounts in varying states of maintenance. One personal, one for my company, one for The Coder Coach, two for clients, and the rest are accounts that were set up for miscellaneous purposes and very few people have those email addresses. I have 2 Facebook accounts, a LinkedIn account, and a Twitter account - although I only tweet professional tidbits because I personally find it a bit ridiculous to let people know what I'm up to at every moment of the day. I also have an instant messenger (IM) account, which one of my clients uses for quick questions.
And that's just "social" media. I am able to VPN into 2 of my clients in order to access their systems, which consist of a logon to the VPN, a logon to their server, a logon to the electronic medical record (EMR), a logon to their coding system, and an encoder. I also have various online memberships (e.g., AHIMA, AAPC) that require passwords to access member-only information. And frequent flier and hotel point programs. I currently maintain over 100 passwords.
In order to maintain all these accounts and passwords, I have my main work laptop, laptops from some of my clients, and an iPhone. I also have a personal laptop, which gets turned on about once every 3 or 4 months because I can't stand to be on the computer when I'm not working. I run dual monitors on my desk so I can look at applications side by side. I have 2 phone numbers, a fax number, and 2 different ways to connect to the internet. In other words, I'm well connected - at least when all the computers are working properly.
I admit - this is extreme. For the typical coder working from home, though, there will be at least a computer and 1 or 2 huge monitors for reading EMR documentation (remember, paperless means no paper - everything is online) and the login credentials to get into a VPN, remote server, and whatever systems you'll be using. When something goes wrong or doesn't work properly, you are the first line of IT defense. You can't just get an IT guy over to your house right away.
So if you want to be a coder and work from home and you aren't on Facebook because it's "too complicated," think about either changing your reason for not being connected, get connected, or find a new career that doesn't involve computers. And try to filter what you tell a potential employer about your issues with technology. As medical records move to an electronic format, you will need to be more tech savvy. After all, if my dad can do it, so can you!
I'm not one of those people who is afraid to "friend" my parents. They're actually pretty cool and I get along well with them. Plus, I subscribe to the idea that if I'm uncomfortable having my father read it, I shouldn't be posting it on Facebook to begin with. But my dad has only recently become semi-tech savvy. I received my first email from him about a year ago. So getting a Facebook request from him was major. Mom's request came in soon after his and was a little less shocking because she's into gadgets and is one of the few people I actually text.
My point (and I do have one) is this: so many people tell me they don't do Facebook because it's too much work. These people are often people who are looking for jobs. And all I can think of is, if Facebook is too much work and you want to be a coder (and potentially code from home), you are looking into the wrong business.
Let me demonstrate. I have 7 email accounts in varying states of maintenance. One personal, one for my company, one for The Coder Coach, two for clients, and the rest are accounts that were set up for miscellaneous purposes and very few people have those email addresses. I have 2 Facebook accounts, a LinkedIn account, and a Twitter account - although I only tweet professional tidbits because I personally find it a bit ridiculous to let people know what I'm up to at every moment of the day. I also have an instant messenger (IM) account, which one of my clients uses for quick questions.
And that's just "social" media. I am able to VPN into 2 of my clients in order to access their systems, which consist of a logon to the VPN, a logon to their server, a logon to the electronic medical record (EMR), a logon to their coding system, and an encoder. I also have various online memberships (e.g., AHIMA, AAPC) that require passwords to access member-only information. And frequent flier and hotel point programs. I currently maintain over 100 passwords.
In order to maintain all these accounts and passwords, I have my main work laptop, laptops from some of my clients, and an iPhone. I also have a personal laptop, which gets turned on about once every 3 or 4 months because I can't stand to be on the computer when I'm not working. I run dual monitors on my desk so I can look at applications side by side. I have 2 phone numbers, a fax number, and 2 different ways to connect to the internet. In other words, I'm well connected - at least when all the computers are working properly.
I admit - this is extreme. For the typical coder working from home, though, there will be at least a computer and 1 or 2 huge monitors for reading EMR documentation (remember, paperless means no paper - everything is online) and the login credentials to get into a VPN, remote server, and whatever systems you'll be using. When something goes wrong or doesn't work properly, you are the first line of IT defense. You can't just get an IT guy over to your house right away.
So if you want to be a coder and work from home and you aren't on Facebook because it's "too complicated," think about either changing your reason for not being connected, get connected, or find a new career that doesn't involve computers. And try to filter what you tell a potential employer about your issues with technology. As medical records move to an electronic format, you will need to be more tech savvy. After all, if my dad can do it, so can you!
Wednesday, July 7, 2010
Getting Through an Operative Report - Without Crying
One of the things I love about the mentoring I do for students is it reminds me of what it was like to be a newbie. And I don't just mean the excitement of being on the cusp of a new career. I am also grateful to be humbled and reminded that I knew absolutely nothing when I got started. These days when I stand in front of an audience of coders or students and teach the latest and greatest on whatever topic I'm discussing for that day, it's the culmination of years of experience and hours (or weeks) of research and preparation. But you might be interested to know that in my first coding job I did come home from work on more than one occasion in tears.
I can't explain that helpless feeling when you've trained so hard - and studied and taken numerous tests and graduated, etc. etc. etc. - and you land that first job and they hand you an operative report. And you freeze. Because it's like Greek. You have no idea what to do. Where are the short coding scenarios you learned in school? What does that first paragraph really say? You know you could find the code if you could just figure out what the heck the darn report says (incidentally, I now consider myself trilingual: English, medical terminology, and coding!). You know you're qualified, but are you really?
So I sometimes forget when I'm working with new students what it was like. Of course, there are still days when I feel like crying because I keep getting myself into uncharted territory. I actually relish researching and "figuring out" things that other people may abandon because they are too foreign or "difficult." But it wasn't always that way. I used to be an overconfident novice coder who, when a chart was placed in front of her, did a lot of tap dancing to make it look like she was competent. The good news is, 15 years later, I feel competent (most of the time anyway!).
The Word Search
I've worked in coding education now for about 8 years. In that time I've been asked to work on a lot of different projects related to coding education. In addition to training coders, I've been asked to evaluate people to see if they would make good coders. And I always start with the word search test. Do you like word searches? If not, you might want to consider a different career. Because coding is one big word search. You have to decipher the medical record (or operative report) and decide which words are important and which ones you can ditch.
Bunionectomies are a Kick
The first time I was given a bunionectomy report to code, I'm pretty sure I cried. After all, the procedure title was something like "Mitchell-Chevron," which meant nothing to me. And I knew enough about coding to know I had to read the report to figure out if it really was a Mitchell-Chevron. And the report was surely about 4 pages - pretty standard for a thorough podiatrist. And when I went to a class to learn how to code bunionectomy procedures, I realized that out of the entire 4 pages, I focused on about 3 sentences. That was it. The rest was coding garbage. In case you're wondering, a Mitchell-Chevron bunionectomy involves removing the medial eminence (AKA bunion) and making an osteotomy (bone cut) into the first metatarsal (the foot bone connected to the big toe). I'm still amazed that it takes 4 pages to describe that.
Deciphering the Operative Report
I am often asked to explain how to decipher an operative report. Well, it depends on the procedure, really. And if you are a new coder and you ever have the opportunity to go to a seminar where they will present case studies, this is the best way to learn. I've taught dozens of classes and nothing drives home my point more than walking through the cases and coding them. But I will give you some basic elements here to get you started. While these rules don't apply to all specialties (e.g., interventional radiology has "special" rules that drive the even the most experienced coders - that would be me - batty!), this should get you started on some of those basic surgical reports.
I can't explain that helpless feeling when you've trained so hard - and studied and taken numerous tests and graduated, etc. etc. etc. - and you land that first job and they hand you an operative report. And you freeze. Because it's like Greek. You have no idea what to do. Where are the short coding scenarios you learned in school? What does that first paragraph really say? You know you could find the code if you could just figure out what the heck the darn report says (incidentally, I now consider myself trilingual: English, medical terminology, and coding!). You know you're qualified, but are you really?
So I sometimes forget when I'm working with new students what it was like. Of course, there are still days when I feel like crying because I keep getting myself into uncharted territory. I actually relish researching and "figuring out" things that other people may abandon because they are too foreign or "difficult." But it wasn't always that way. I used to be an overconfident novice coder who, when a chart was placed in front of her, did a lot of tap dancing to make it look like she was competent. The good news is, 15 years later, I feel competent (most of the time anyway!).
The Word Search
I've worked in coding education now for about 8 years. In that time I've been asked to work on a lot of different projects related to coding education. In addition to training coders, I've been asked to evaluate people to see if they would make good coders. And I always start with the word search test. Do you like word searches? If not, you might want to consider a different career. Because coding is one big word search. You have to decipher the medical record (or operative report) and decide which words are important and which ones you can ditch.
Bunionectomies are a Kick
The first time I was given a bunionectomy report to code, I'm pretty sure I cried. After all, the procedure title was something like "Mitchell-Chevron," which meant nothing to me. And I knew enough about coding to know I had to read the report to figure out if it really was a Mitchell-Chevron. And the report was surely about 4 pages - pretty standard for a thorough podiatrist. And when I went to a class to learn how to code bunionectomy procedures, I realized that out of the entire 4 pages, I focused on about 3 sentences. That was it. The rest was coding garbage. In case you're wondering, a Mitchell-Chevron bunionectomy involves removing the medial eminence (AKA bunion) and making an osteotomy (bone cut) into the first metatarsal (the foot bone connected to the big toe). I'm still amazed that it takes 4 pages to describe that.
Deciphering the Operative Report
I am often asked to explain how to decipher an operative report. Well, it depends on the procedure, really. And if you are a new coder and you ever have the opportunity to go to a seminar where they will present case studies, this is the best way to learn. I've taught dozens of classes and nothing drives home my point more than walking through the cases and coding them. But I will give you some basic elements here to get you started. While these rules don't apply to all specialties (e.g., interventional radiology has "special" rules that drive the even the most experienced coders - that would be me - batty!), this should get you started on some of those basic surgical reports.
- Rule 1 - Doctors Lie: Admit it, you watch House and have heard him say on more than one occasion that patients lie. Well, Dr. House, I would like to point out that doctors lie too. They will state the procedure one way in the title and then proceed to describe a completely different procedure in the body of the report. For example, the doctor may state a left heart catheterization was done, but after reviewing the report, the catheter never made it all the way to the heart - only to the coronary arteries. So keeping this in mind, you should never believe what you read in the procedure title. Honestly, I rarely even read the procedure title anymore - it's often fiction. As for Dr. House, I would love to see a strong-willed coder have it out with him on the show about his documentation, which I'm sure is a mess.
- Rule 2 - Get a Medical Dictionary: There's no excuse anymore. When I learned how to code, we were still using Windows 3.1, so there was no way the hospital was using the internet. But even without online resources, I had a medical dictionary on my shelf. And it was used often. How will you know if something is important if you don't even know what it means? While you're at it, make sure you also have access to an English dictionary. I know it's a novelty, but you will also find complex nonmedical words in the operative report (or even in your code descriptions). If you don't know what it means, look it up. Tedious, I know, but you will learn. Of course, you might feel like Billie Dawn from Born Yesterday, but you will learn. (Don't understand the movie reference? Look it up!).
- Rule 3 - Just Like Ragu, It's Probably in There: In school we hear terms like "it's bundled" or "separate procedure" but what does that really mean? Well, it means it's integral to the main procedure and don't code it out separate. What's included? Well, pretty much anything that has to be done in order to accomplish the main procedure. Taking out an appendix? Well, then the incision (or creation of ports for laparascopic instruments) is included. So is the closure at the end of the procedure. I don't know about you, but if I have my appendix taken out I sure hope the physician remembers to suture me closed at the end. All those things are like regular ingredients in Ragu pasta sauce - tomatoes, oregano, garlic. It's in there! So don't code each component out separately. Now, had they decided to do a liver biopsy while in there, that's different. That's like throwing a banana in the pasta sauce. So it gets coded separately.
- Rule 4 - You Will Only Use 10-20% of the Operative Report: Don't feel like you need to use every word in the operative report to code the case. The fact is, the operative report isn't about you, it's about the patient and it's a communication tool for clinicians. It just happens to double nicely as a recording of everything that happened to the patient and can substantiate coding and billing. It's up to you to determine what's important in the documentation. There's a reason we use coding for billing - your codes actually fit on a 1-page claim form so the insurance company doesn't have to read through every single medical record.
- Rule 5 - Know the Procedure: Okay, maybe I should have led off with that one. Medical terminology is, quite literally a foreign language. In fact, it's at least two foreign languages: Latin and Greek. So when you say "it's Greek to me," you're being quite literal. A really good medical terminology class will solve a lot of problems. You may think esophagogastroduodenoscopy is a really big word until you break it down and realize it's visualization (scopy) of the esophagus (esophago), stomach (gastric), and part of the small intestine (duodeno). You also need to know your anatomy. You need to know when they operate on a structure that's part of a bigger structure (e.g., mesentary of the intestines) vs. a different organ altogether (like in the appendix/liver example above). After you learn medical terminology and anatomy and physiology, that's half the battle. The rest of the battle can typically be solved with Google. Come to think of it, there are few things that can't be solved with Google. I'm pretty sure there will be a support group some day for Google-aholics, but in the mean time, I highly encourage you to google a procedure if you don't know what it is. I never remember what a Whipple procedure is. But I can google it in about 10 seconds. Just be careful which website you select from your Google search list - something from the Mayo Clinic is probably more reliable than lazy-Dan-explains-medical-procedures.com.
- Rule 6 - There is Crying in Coding, Just Don't Let Anyone See It: Oh, how I wish I could tell you I had that one down. But I'm pretty transparent when it comes to being frustrated. And I've had students cry in frustration when trying to code case studies. But try to minimize your public displays of tearful frustration and remember this - we've all been there and this is hard. It's okay to not know all the answers all the time.
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.
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.
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.
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.
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