Medical informatics/chart review/coding good stepping stone to LNC

  1. Hello, I am considering going to work for a company that is growing rapidly and does chart reviews ect. I have been a nurse for 12 years. Peds home care and OR have been primary specialties. Just wanted some insight if you think this type of work would enhance background to get into LNC in the future. Thank you in advance for your reply.
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    About Itshamrtym

    Joined: Jun '07; Posts: 486; Likes: 119


  3. by   tomboynurse
    Hi, there!
    I just got a temporary job reviewing charts for a local health insurance company.
    They even have a remote access, so I can work from home if I want to. However, I decided to have my mom look after my child the first few months I work for this insurance company just to network with people in the company.

    Chart review jobs for RNs is a great job if you want to stay home with your child/ren, and your family only needs supplemental income here and there. Chart review jobs is not for you if you are single, and need a job that pays good medical/ dental benefit. It's also a great way to break into insurance companies.

    I accepted this temporary job only because I'm planning on breastfeeding my first child for the next 1.5 years... But then, I searched and found local hospitals that hire LPNs/ RNs/ Coders with 5 year clinical experience to review their charts for certain projects and legal claims. There is a lot of opportunity to have steady income if you sign up with a couple of local hospitals and insurance companies to review charts for them.

    I also recently learned that as an RN, you can write and pass Certified Professional Coder (CPC) Certification via AAPC (American Academy of Professional Coders), and work as an RN coder. I used to think RNs have to go back to school to become a coder with RHIT or RHIA title, but I was wrong. On the one hand, hospitals and doctors' offices hire RHIT or RHIA coders to do most of their coding work. On the other hand, insurance companies hire RN coders with CPC certification to handle their coding work because RNs know their way to navigate charts and health information. The only draw back with RN coder position is that you cannot work from home for these positions. You have to go to meetings, and work closely with doctors and quality control dept at insurance companies, so you have to go into the office everyday. You also need to brush up on your medical terminology and anatomy if you've been a nurse for 10+ years in a very specialized area. For one, you may not remember what you learned in your anatomy class 20 years ago. For two, you may not recall some of the terminologies commonly used in medical areas you have never worked in.

    You can also earn a certification to work as an RN auditor. It's called CPMA, and you can get it through the same organization you can obtain your CPC certification: AAPC. Most insurance companies expect their auditors to have a broad knowledge of insurance reimbursement system and coding, so I'd recommend you get both CPC and CPMA if you want to work as an auditor. I believe RN auditors in general demand higher salary. You can even work as a contractor on special projects as an RN auditor. So, it's a very rewarding career. I actually know someone who broke into one of the largest health insurance company by becoming a nurse auditor.

    Moreover, there is a lot of jobs out there to work as a utilization manager. It's so rare to find a nurse who knows a lot about medical insurance and clinical knowledge that some of the positions as a utilization nurse in some hospitals and insurance companies remain vacant for years.

    Hope most nurses find this post helpful!
    Don't be discouraged with one of the specialty areas you just tried didn't work out for you.
    Don't you dare think your nursing career is over when you hurt your back lifting your patient(s).
    Both of the above happened to me, and I still manage to get a job in health care industry.
  4. by   Aviationurse
    Wow thank you so much for the info tomboynurse....i do have a bad back...knees...did not make it to my specialty...(legal nursing...dialysis...psych)...thought about working in the casino as a bartender or a casino door greeter to supplement my income as no one around me is hiring.....
  5. by   chiko
    Thank you so much for the information tomboynurse ,it's very helpful.