Becoming A Medical Coder

As I near the completion (finally!) of my certification in medical coding, I’ve had some people ask me about my schooling and how I got here. It made me ruminate on the ways in which all the disparate things I’ve done before now have neatly come together into this one profession.

To start, I grew up the daughter of two veterinarians. My Dad owned a vet clinic and my Mom worked first as the vet on staff for their county animal control and then as a relief vet in private practice. (Mom and Dad practiced together before my sister and I came along.) So, medical jargon was the norm in my house. Mom and Dad discussed surgery over the dinner table at night; we listened to Dad take emergency calls from clients; I helped at the clinic every now and then; I watched and assisted as my Mom or Dad spayed/neutered various pets of mine.

My Dad even put stitches in my toe once. But that’s another story entirely.

When I went to college, I studied Archaeology. I have a BS in Anthropology from Michigan State University. I concentrated on Classical Archaeology – Rome and Greece – so I took two years of college Latin. (I graduated before I could start taking Greek.) I also enjoyed Physical Anthropology, in particular Human Origins, which includes a fair amount of anatomy knowledge. The summer between my junior and senior year of college, I completed an archaeological field school that taught me the process of how a dig works.

During the summers of my college years, I worked for the local urgent care in the billing office. I wasn’t a coder or biller then, I was just a general office grunt but one picks up more than just one’s own job if one pays attention. And I did. I gained knowledge in the workings of insurance companies, how claims are filed, medical records keeping, etc. This was in the days before the electronic medical record so it was A LOT of paper management.

When I graduated from college, I made the decision not to go to graduate school. It’s a long story that is partially bound up with the guy I was supposed to marry and didn’t, but suffice it to say that the world of academia wasn’t really something I thought I could successfully navigate. I still think that – the required political maneuverings would have me eating my foot in about 2 seconds flat. That’s assuming I didn’t tell my advisor to stuff it somewhere in the Ph.D. process.

Instead, I worked a series of clerical/administrative assistant type jobs. One of those jobs was as a legal secretary for a law firm that did largely subrogation law. That’s insurance law. Before motherhood, that was the hardest 40 hours a week I ever worked. (Motherhood, however, is the real butt kicker.) The work was incredibly detail-oriented and fast paced to boot. I had no experience as a legal secretary at the time so I had a steep learning curve. But I learned A LOT from that job, not just about the law, and I’m glad I did it.

When I left that job, it was to move cities, come to Pittsburgh, and get married to Scot. I worked for Carnegie Mellon for 4 years as a faculty assistant. I supported 10 professors, all of whom had a claim on 20% of my time. You do the math.

I lost that job in a layoff when I was newly pregnant with Liam – just 7 weeks along. I worked a temp job or two while pregnant but ultimately decided to just be a stay at home parent a few months before I was actually a parent.

That snowballed into a decade at home, at the tail end of which I decided to go back to school to become a medical coder.

I did my program entirely online through AHIMA – it was entirely self-directed and self-paced. I had intended to be done with school by October 2015 – when the ICD-10 code change became effective – but life circumstances prevented that and I’m about 9 months late to the party. Code change was a big deal, with many places scrambling to find coders certified in the new code set in time for implementation. I knew the job market would be open to me, even as a newly minted coder, because I focused my efforts on learning the new coding system just as it was about to be implemented.

I also picked up a part time job that allowed me to gain some experience while I was finishing school.

So how does this all fit together?

  • I grew up in a medical household. That meant that when it came time to learn anatomy and physiology, pathophysiology, and pharmacology I started with more that just the basic working knowledge of “the heart has 4 chambers.”
  • Between growing up as I did and taking two years of Latin, learning medical terminology came easy to me.
  • Archaeology taught me analytical thinking. An archaeological dig is nothing more than a large puzzle in three dimensions. You have to be able to take disparate elements and piece them together to form a larger picture. Abstracting medical records to code them out is no different. You look at the full record, extract the relevant information, and turn that into codes that report the full picture of a patient’s illness.
  • Working in a medical billing office is pretty clearly relevant here. I saw HCFA forms and how they were filled out. I learned how to keep medical records. I learned the convoluted ways in which insurance companies work.
  • Working at the law office and at Carnegie Mellon taught me time management and attention to detail. There is nothing so important in coding as the details. The biggest improvement in ICD-10 is that it includes expanded specificity. Oh? The patient is a diabetic? Type I or Type II? Insulin dependent? Any neuropathy? All of those questions affect the code chosen. You have to pay attention.
  • Then there’s my current job. It gives me experience I wouldn’t otherwise have had. I code, I bill, I call insurance companies, I maintain medical records, I stay aware of HIPAA compliance.
  • Last, motherhood. There is nothing so hard, so stressful, so exhausting as being a mother (or a father, but I’m a mother so that’s my experience). There are a thousand skills I use in raising my kids that translate to the workplace.

I’ve done so many different things in my life but it seems they were all leading me here. Finally, at the age of 40, I am on the cusp of having a REAL career. It took me a long time to get here.

My parents have always said that no education is ever wasted and they never made me feel like I wasted mine (or their money) for getting a college degree in a field I don’t work in. It turns out they were right; it wasn’t wasted. It was just one more step leading me here.

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Employed Again

Guess what? I got a j-o-b!

The seeds were planted many months ago. One of my closest friends, Dawn, was telling me about her husband’s office. He’s a psychologist who he practices independently and was needing help with some of his billing. I said “Dawn, I could do that! And I would be cheap!”

And there it sat. I didn’t really expect to get a job out of it. It was a conversation between friends about life frustrations, not a job interview.

So, imagine my surprise when Dan approached me a couple of weeks ago and asked to talk to me about this very topic. His current methods weren’t working very well anymore for a number of reasons and it was time to look into other possibilities. I sat down with him one Sunday to discuss his needs, my experience, my schooling, my schedule, etc. I walked out of that meeting with a job.

I will still be finishing school. I have one semester left to go that I’ll be registering for in the next few weeks (as soon as the new online learning platform is up and running). My work schedule is going to be very flexible so I will still be able to be home with the kids when I need to be. There is some work that I will be able to complete from home as well.

I sat down last week with the person currently doing this work and got started learning the ropes. I’ll be sitting down with her again on Saturday. I’m eager to get up and running with this because I feel like there is a lot of good that I can do here – billing, organization, records – they all need attention and I can totally get that in hand.

I’m not going to be bringing in a whole heap of money but it’s a place to start and a foot in the door. I get an enormous amount of flexibility about my work schedule which is worth its weight in gold (if such a thing could be weighed). I’m excited to be able to help my friend and her family by regulating some things in their lives.

So, there it is. After a decade home with the kids, I am suddenly employed again and I owe it all to Twitter!