Reader feedback: Gap between coding education and on-the-job needs?
In the December 2010 issue of the Health Care Careers e-Letter, we received the following e-mail from a reader who is a Certified Coding Associate:
"I wonder about the gap between my medical coding education and the real world of coding in the job market.
"When I applied at my community college for the Medical Coding Certification program, I was told that this certification would give me what I need for an entry-level position in Medical Coding for a hospital or physician’s office. Well, it's been six months since graduation from my six-course, 21-credit certification, and all of the coding jobs I've seen posted require two to five years' experience.
"There needs to be some sort of standardization in the education so that experience in the form of internships or apprenticeships are all part of certification programs. My community college is definitely lacking and is misleading students like me who believed I would have what I need to start a coding career."
In response to this article, we received the following feedback:
I'm experiencing the same problem, although I took courses in both medical coding and billing by correspondence, as well as a electronic billing program course through my community college. But the correspondence school I went through didn't have an internship and simply tried to drive home that I didn’t need it. I just needed to be assertive about how good and practical my training was. Well, after looking around locally for internship/volunteer opportunities with private offices, hospitals, clinics, and the VA, I haven’t been able to find anything. Someone through a temp agency with experience in the coding world told me that as far as he knew, without an internship to give me the needed experience, I wasn't ever going to find any opportunities. I feel a little disappointed.
I can understand the frustration of the coder who was wondering if there was a "gap between coding education and on-the-job needs."
I am not in a community college and chose not to attend one for that very reason the person stated. The school I chose has a year-long course that encompasses everything we are supposed to need to work in the field as a CPC: terminology, computerized billing/coding/scheduling/insurance, as well as CPT/ICD-9-CM HCPCS. The end of the course, the last two semesters are for certification training (to take our test) and an internship, which will hopefully lead to employment.
We have also been looking and checking the job market and have found that most positions require at least two years' experience, with very little for entrance level.
It is frustrating to think that after all our hard work, hopes and dreams, we will not get hired because no one will want someone with little hands-on experience.
An immediate hire is what we need to use our new knowledge as well as pay for the schooling.
I am the coordinator of medical office programs at a two-year community college. One of my programs is a 30-credit hour certificate called Health Insurance Specialist. Our students must complete a 160-hour externship their last semester in school.
Finding and maintaining externship sites is very time-consuming for me, but I want our students to have a real on-the-job experience before they graduate. I can't promise them that it will be a "perfect" experience, but it is experience just the same. They can also put this experience on their resumes. Most of our students are finding either part-time or full-time jobs. It seems that most of the other colleges in our area either do not offer an externship with their certificates or have discontinued offering one.
Yes, I feel there is a gap between coding education and on-the-job needs. I took an accredited coding courses as well, and everywhere I went I found that you need a minimum of two years’ experience.
My college made it sound even easier to work from home. I attempted that but unless you are established with experience no one wants to take a chance on your services. I got lucky and got a job with a small local health department, but I don’t get to use my coding schooling very much in my job now. I feel I wasted my time in school for a piece of paper.
I agree with the reader wholeheartedly. Unfortunately, that is not an isolated event. Our health system in Northeast Ohio requires similar experience before hiring in the Medical Coding and Billing departments.
Yet, schools have a difficult time including any kind of internship with the training. Gaining proficiency is a rigorous process, and we are not likely to allow students to "cut their teeth" in this department. In our own system, after a person is hired, they are then audited for a year in their position. We have our own employees who completed a medical coding course, are certified, and still not qualified to be hired by our health center. We are working on that issue internally to provide "internships" for these employees, so that they may gain the requisite experience to be considered for an open position.
Note: Under the American Health Information Management Association (AHIMA) Approved Coding Certificate Program (ACCP) criteria, an approved coding program must have a professional practice experience—either field-based externship, virtual simulation, or a hybrid combination.
I spent $17,000 on an education to become a Medical Coder and Medical Biller through the National Association for Health Professionals (NAHP). Now, I am unable to obtain employment because this certification is not recognized through the AAPC or American Health Information Management Association. The teaching was equivalent to that of the AAPC (I also completed an AAPC program), but more thorough as it was eight months long as opposed to three months.
Does this mean I have to test through AHIMA or the AAPC and spend even more money? That doesn’t seem reasonable or fair.
I would like to tell you a little bit about my failure to secure employment.
I was very excited when I graduated in December 2008 with an AAS degree in Health Information Technology/Medical Records from Alfred State College in Alfred, New York. I did my entire degree program online and I felt that the courses were well taught and that the instructors were very helpful. It was a grueling two years, but I knew that I would be well prepared and ready to enter the healthcare industry as a health information technician.
I studied for the Registered Health Information Technician (RHIT) exam for the next couple of months and passed the RHIT exam in October 2009. At last, I believed, the RHIT credential after my name would help me find employment. There was, however, one barrier could not overlook. I had no experience!
My college did have an internship program during my last semester, but unfortunately I was not able to secure a hospital, medical center, physician’s office or other health care setting that would provide me with what I really needed, which was hands-on experience. Instead, I did a “virtual” online program, in lieu of the actual hospital setting. I then applied for at least 30 job openings, even entry-level positions, but without 2 to 3 years experience doing medical coding/billing, I was out of luck.
This was my second career choice in a field that has always interested me, and I am aware that I will not obtain or succeed in this field without any experience.
I decided that I will no longer remain a member of the AHIMA or my local and state associations. I will also not seek continuing education units in order to maintain my RHIT credential. Every day I say to myself, “What's the point?”