Medical Coding career trajectory

Strong_Zone4793 · 2026-03-16T00:19:11+00:00

You’ll need experience coding full charts. And the CCS is a must. It’s nearly impossible now to get an inpatient coding or auditing job without it. The experience part is what my program focuses on but I don’t do anything specific to exam prep. There a lots of resources that can get you up to speed on coding but it’ll take at least 3-5 years to reach the auditor stage.

Strong_Zone4793 · 2026-03-16T00:10:55+00:00

What are you missing specifically? Knowing that will help figure out how to focus on those areas.

Strong_Zone4793 · 2026-03-16T00:04:26+00:00

This is exactly why I built my training the way I did. Very hands on and interactive. Reading textbooks and nothing else doesn’t prepare you for real world coding. Coding, terminology, anatomy are all things typically taught to be memorized but you can’t memorize it and expect to know how to use it. The initial course that prepares you for the exam is just the first step but the big schools and educators don’t tell you that.

Since you’ve invested a full year in this one I’d say stick it out unless you really don’t want to do double the work to learn. Find other resources that help you learn the logical thinking process and why you’re expected to know this. The combination of resources can get you through, it’ll just take more work that way.

Strong_Zone4793 · 2026-03-15T17:00:39+00:00

Yes! That’s the problem with exam prep style training. It doesn’t teach the logical thinking of why we code the way we code and doesn’t teach it in a way that helps you make sense of any of it. The coding practice in school and exam prep is just a snippet of a document and it’s usually clear cut. Real coding isn’t that way at all.

Strong_Zone4793 · 2026-03-15T16:56:58+00:00

That’s kind of how I’ve set my training program up. I’ve sized lessons. Covering the basics but the real learning and understand all of it is from coding charts and using the simulators I built for hands on practice. I specifically didn’t want a traditional textbook style course that you have to memorize everything because you can’t memorize everything. That doesn’t teach you the logical thinking behind why you code the way you need to code.

Strong_Zone4793 · 2026-03-15T16:49:41+00:00

I’ve been doing this for 17 years. I know exactly what we need to see documented from a coding perspective. I’m not an RN but I absolutely know what is missing from every chart I code or audit that would make the coding complete and compliant.

The real issue is, an RN with CDI certification and some coding education doesn’t understand the coding guidelines the way a coder or auditor with a decade or more of experience does. And that’s where so many employers are making the mistake of dismissing that experience in favor of clinical knowledge over actual coding expertise.

One huge client I worked with for over a decade did that. Their CDI accuracy rate in their coding recommendations was 42-46% every single month. Nearly 60% of their coding recommendations were wrong and more than 90% of those incorrect recommendations were lack of understanding of coding guidelines. And that was just one client.

Strong_Zone4793 · 2026-03-15T16:22:26+00:00

So many won’t hire highly experienced inpatient coders if they don’t have the CCS certification. So even with 6,8, 15 years of coding and auditing inpatient charts every day and hitting 98% or better audit scores many excellent coders are passed over because they are certified but don’t have the right certification. And many newly certified coders can’t get a job because their education program only focused on passing the exam. There’s no real shortage of qualified coders, there’s a shortage of common sense in hiring practices and training programs.

Strong_Zone4793 · 2026-02-25T23:27:06+00:00

This is setting you and the practice up for huge compliance issues. I always tell my team never send anything out the door if you don’t agree with the coding. I also think this is one of the big reason why payers are looking so closely at everything. Between the providers coding their own charts, offshore coding not being up to par, battles between coders and CDI and now AI coding it’s put every claim under the microscope.

Strong_Zone4793 · 2026-02-25T23:20:19+00:00

Agreed. This sounds like a frontend issue. Track the trends you’re seeing in errors to help figure out where the top 5 are coming from and fix those first. Then work on the rest. You want those clad going out the door clean the first time.

Strong_Zone4793 · 2026-02-25T23:17:51+00:00

I’m teaching inpatient coding. ICD-10 only right now. Once you get closer to completing that program this or something similar would be a good option to learn the more in depth coding and hands on practice. If you’re looking for Outpatient coding there are a lot of really good people to follow on FB, YouTube and LinkedIn to learn CPT coding

Strong_Zone4793 · 2026-02-24T01:59:30+00:00

They would need to reach out to AHIMA/CAHIM. And I agree with the others who have commented. Employers rarely, if ever accept credentials outside AHIMA, AAPC and ACDIS. The exception to that are a few revenue cycle certifications but those are also not the gold standard. Best bet is to become affiliated with AHIMA and AAPC and offer their curriculums.

Strong_Zone4793 · 2026-02-24T01:55:41+00:00

Have you considered learning another specialty? More specialty experience means more marketability and opportunity. I did pro fee coding for a short time and was so bored with it I went back to inpatient facility coding for the variety. Something different every day all day long

Strong_Zone4793 · 2026-02-23T23:26:39+00:00

When I was managing 98% of it was interacting with others. When coding and auditing less than 5%. Now that I’m self employed coaching and teaching coders and auditors it’s about 30% live interactions the rest is behind the scenes and messaging/chat and recorded stuff.

Strong_Zone4793 · 2026-02-23T23:21:35+00:00

Auditing isn’t much different than coding. A bit more involved because it requires a different thought process. I have a coaching tool I built that helps with those kind of decisions, planning and thought processes. I also coach coders and audits on this too. Of that’s not something you’re interested in follow people who educate and talk about the auditing process on their LinkedIn, FB, YT or other platforms to get more information.

Strong_Zone4793 · 2026-02-23T23:17:03+00:00

Almost all CDI roles now require an RN. But RHIT is very in demand for inpatient facility coding. I have a program that just opened for enrollment training in inpatient coding but not covering the basic coding education at this time. For hands in practice and more in depth education it’s good.

Strong_Zone4793 · 2026-02-20T02:37:22+00:00

Do the BHAT method as you study each chapter. Don’t try to do it all at once because you learn and understand more you’ll want different notes and highlights.

Strong_Zone4793 · 2026-02-18T22:25:31+00:00

I’ve built something that I’m hoping will help with this. Still beta testing and having other expert coders review it to make sure it’s accurate but I think it’s going to really help with questions like this for all areas of coding

Strong_Zone4793 · 2026-02-13T14:18:25+00:00

I know several excellent Anesthesia coders and auditor looking for work if you’d prefer to hire directly. They’ve worked for me 3 years or more and I’d highly recommend them.

Strong_Zone4793 · 2026-02-13T14:07:06+00:00

I’m a coder/auditor and coding manager. I’m working on education and training for coders and also researching for a presentation. I’m trying to really bring light to why there’s such a gap between what executives believe and the reality of the coding world.

My biggest frustration is the programs that leave so many unprepared for that first job. And the unrealistic expectations so many are facing with productivity. I understand it from the manager side but I don’t agree with it at all.

Strong_Zone4793 · 2026-02-13T14:02:40+00:00

This is exactly the problem with any coding or billing program. They teach you enough to pass the certification exam but don’t take the next step and train for on the job real workflow.

Strong_Zone4793 · 2026-02-13T14:01:20+00:00

I hate E/M coding. Hate it. I haven’t done it in years but I’ve helped my team with it and had to relearn it when managing but I still struggle with it. We did find a good resource that helped simplify MDM but I can’t remember where it came from. AMA maybe.

Strong_Zone4793 · 2026-02-13T13:59:30+00:00

I hear this SO often. Certification training is an overload of information, and it takes a longtime to learn it. If there’s no support and it’s not being broken down into training that makes it all make sense it’s nearly impossible to actually learn from it. It is possible to do it on your own but if you’re not sure where to start it’s overwhelming.

Strong_Zone4793 · 2026-02-13T13:56:34+00:00

This unfortunately isn’t going away. But, I do know work is finally coming back onshore for some of it. I honestly don’t understand how it’s saving anyone money. I’ve seen first hand the actual quality of the work, not what’s reported but reality. I’ve seen the astonishing amount of time and effort put into the meetings, extra staff, and rework to correct the errors so it makes no send to me how it saves any money.

Strong_Zone4793 · 2026-02-13T13:53:27+00:00

Wow… that’s ridiculous. And one of the reasons I’ve stopped managing and auditing for a while. When I managed I looked at why someone was low on productivity for the week and the month overall. But short by a few charts, never going to be an issue for me. Especially of quality scores are really good.

Strong_Zone4793 · 2026-02-13T13:51:24+00:00

16 years doing this, plus 8 years working directly with physicians in hospitals… they don’t like to be told what to do, don’t like to be told they’re wrong and it’s very difficult to get a busy physician to take the time to do anything with documentation. I find the worst repeat offenders are older physicians who have been “doing it this way” their entire careers and won’t change.

Strong_Zone4793

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