I went into coding several years ago when my back died and I could no longer stand long enough to do clinical nursing. There is a large group of ER physicians around where I live that hires nothing but RNs to code their bills. Only stipulation is that they like these RNs to have had some critical care experience, if possible, and they train the RNs on how to code. When I went there to apply for a job, they weren't interested in me because I was already trained as a physician coder and had already worked for two years for another large ER physician group in another state. I was told outright that they felt I was "contaminated". I was greatly bothered by this because coding is highly regulated and you can be charged with a federal crime if you are involved in any coding fraud. To this day, I think they might be doing something "funny" with their billing that they don't want an appropriately trained coder working there.
I originally went to a vocational school to learn coding. But, here is what I have since learned. There are two types of coders: physician coders and hospital coders. To be a hospital coder (code inpatient and outpatient hospital bills) you must be trained at a community college that has an AHIMA accredited coding program. It is actually cheaper to get the education this way. You can find these programs on the AHIMA website (http://www.ahima.org/
). There are really only 3 classes you need to take: ICD-9 Coding, Advanced ICD-9 Coding, and CPT Coding. You can complete these classes in two semesters. With an RN they will usually waive the anatomy and physiology pre-requisite requirements. To be a physician coder you need to have classes in ICD-9 Coding and CPT Coding. Hospital coding pays more. Physicians are more likely to hire anyone who has any kind of coding experience depending on how careful they are about their billing practices. Hospitals are more picky because of the Medicare rules they have to follow.
Don't do a home study course unless it is the accredited one through AHIMA. Facilities and physicians with any kind of integrity and concern about doing their billing correctly won't even hire you with that kind of training. They can get slapped with pretty stiff fines and even jail time if they hire a coder who is taking short cuts and coding things wrong. With an RN as well as training as a coder, you should have no problem getting a job. The first job, however, is usually the hardest to get. If you go to a community college, the instructors are usually a big help in getting you your first job. As a coder, you are primarily reading doctor's dictations (discharge summaries, H&Ps, ER summaries) and coding the final medical diagnoses and procedures that were performed so the doctor and/or facility can be paid. In some cases where typed dictations are not done, you are reading physician hand writing. Part of coding is making sure that specific documentation by the doctor is there or else no bill can be generated.
By the way, the ER group that I worked for had 14 coders and 12 of them coded at home. They had to come into the office twice a week to pick up and drop off charts. We had a staff coding meeting at least every month that we all had to attend. This is because the various billing and coding rules by the different medical insurance companies were changing all the time. We were required to code 200 charts a day, or 1000 charts a week, with 95% accuracy. A day of our coding was audited once a month and if we coded below 95% accuracy for 3 months in a row, we were terminated. I have heard that in some places the requirement is as high as 98%. This is in places that care about accuracy and collecting the money they have earned. Doctors and hospitals lose a lot of money through careless and inaccurate coding. Inpatient hospital coders generally have to code about 25 charts a day including the statistical abstraction that also has to be done for the state and Medicare reporting requirements (this is something that you are taught about in community college programs).