Karen Chaiken, 2013 Medical Billing & Coding / Office Administration Graduate
Clinical Coding Specialist at The Miriam Hospital (Lifespan)
I believed that I would always be married.
However, married for close to 30 years, it turned out not to be true. After an unfortunate divorce, I needed to create a brand-new beginning—and to earn a living.
I was in a tough place; I needed a full time job—and a lot of help.
In keeping with the traditional role of mother and wife, I had worked part-time jobs, volunteered and kept house. I felt fortunate to have been at home for my daughters while they were growing up.
I knew nothing about medical coding—or that it could be a career.
Shopping at Kohl’s in Seekonk Square, I saw the building across the street, with the large letters “MTTI”—and underneath, the smaller letters that spelled out “Education for Employment”.
When I returned home, I looked up MTTI online.
The life changes that had led me to move to East Providence—and then be shopping in Seekonk that day—felt guided. I scheduled an interview to see if this could be an option for me.
I’m a perfectionist—typically going for what I think I can do well.
Science and math were not my favorite subjects. Because I had been elected ‘Top Business Student’ when in High School, and had studied to be an Executive Secretary (now Administrative Assistant) when I attended Bay Path College (now University), I thought perhaps—YES—I could learn coding!
I enjoyed MTTI’s billing and coding class, the instructors and the warm school environment.
The Career Services Rep recommended me for an internship at The Miriam Hospital, in part because my instructors declared that no one had ever achieved as high a grade as I did on the midterm. The Rep said she advocated for me primarily because of my communication skills and professionalism. I was both amazed and honored!
I met with the then Director of Inpatient and Outpatient Coding.
The interview went very well. I started the internship by practicing on older records—coding the diagnoses for patient encounters.
Although everyone at Miriam was friendly and helpful, I worked largely on my own.
MTTI had taught me the proper way to utilize the CPT Procedural and ICD-9 Diagnostic Books. I was comfortable learning on the job because of what I had learned in MTTI’s program. Without that knowledge, I would not have been successful during my internship.
I missed passing the AAPC Professional Coding exam the first time—by one point.
I re-took the exam, and again missed by one point. Each test is different—and I’ve always had difficulty taking timed tests.
Miriam hired me in a per-diem position.
Wanting to hire me permanently, The Miriam Hospital needed me to first pass the coding exam.
I left Miriam after 6 months for full-time employment with Newport Hospital.
Under the umbrella of Lifespan, I worked for the Manager who took care of the Emergency Department at Rhode Island Hospital. I told Miriam’s Coding Manager to please keep me in mind, should a coding opportunity come along—of course, after I passed the exam!
I was determined to pass the coding exam and to learn all I could.
I continued taking the American Academy of Professional Coders’ (AAPC) practice exams. I was intent on passing the exam before the change from ICD-9 to ICD-10. My perseverance paid off—I passed the exam!
From Lifespan, I went to Southcoast in Fairhaven, MA.
I had worked hard to get to where I could code full-time from home, which is one of the greatest benefits of many coding positions.
While I was working at Southcoast, Miriam contacted me about an open position.
Initially I declined, as I thoroughly enjoyed working for Southcoast. However, I soon learned an organizational change was about to happen. At this time I was the last employee hired. After some thought, I accepted the position back at The Miriam Hospital. From coding the Emergency Department, I was now about to learn coding Observation.
I love coding Observation!
I code the diagnoses and procedures for patients who have come into the Emergency Department and are admitted into Observation, while it is still uncertain whether they will be admitted as a patient in the hospital.
There are many steps to coding Observation.
I especially enjoy charging for medications given to the patient while in the ED, and then in Observation. Rules for the hierarchies and medications make it so interesting to me.
All coders now work for Lifespan Corporate.
Instead of working for one hospital, we work for the whole entity, which provides more avenues for learning. I consider myself so fortunate to be part of such an amazing team of coders.
Things are always changing in medical coding; I enjoy continuously learning.
On the job, I was trained on two Electronic Medical Records Software programs. In addition, I was given on-the-job training for the transition from ICD-9 (ICD: INTERNATIONAL Classification of Diseases) to ICD-10-PCS (PCS: Procedure Coding System) (Hospital) Coding Manuals. All of this, in addition to CPT Professional Coding, is now part of MTTI’s curriculum.
During the winter months, I am working from home.
In the spring, I will alternate between working at home and going into the office. I look forward to the social interaction when I return to the office.
A career in Medical Coding is one of flexibility and opportunity.
A coder can work in a variety of settings and positions, including hospitals, private clinics and private practices. Career paths can range from a Validator position, checking other coders’ work, to an Auditor, who travels to various locations to review the accuracy of coding and even to a position in Management.
Medical Specialty Coding is another option for career growth.
Should I be interested in coding Inpatient or Chemotherapy, I would have the opportunity to do so.
More and more, I see that people need an education for entry into medical coding positions.
In the past, people could enter a coding career by first working in an administrative position—or even the laundry department—in a hospital or health center. No one has time now to train someone on the job—it is expected they will come with the basic knowledge learned at school.
As a Coding Specialist, I am able to support myself.
Pay increases with experience. I’ve had a number of increases during the five years I have been coding.
I have a favorite quote about handling adversity in life.
“Things turn out best for those who make the best of how things turn out.” For me, there is great satisfaction that I have not just a job, but a career.
I have done this for myself—with determination and fortitude—by taking baby steps.
I was lucky to have strong support from my entire family. One thing led to the next, then the next and next—all starting with MTTI.
Initially I was nervous about returning to school to train for a new career.
It was a delightful surprise to find that going to school was fun. At MTTI you feel everyone is in your corner—classmates, teachers, staff & administration. MTTI has the human touch. You can feel the caring.