There are a lot of posts asking this type of question. If you do a search, there is some great advice there.
Here's some of my personal opinion and tips:
1) Someone who finished a coding education (and even practicode) and passed the exam really is not fully qualified to work as a coder independently. The real world is not multiple choice. Things like RVUs, NCCI edits, payor specific policies, etc are barely if at all mentioned in training, but as a coder are things you deal with on a daily (if not hourly) basis.
2) In a perfect world, companies recognize the benefit of apprentice coders and are willing to hire them and complete their training. Unfortunately, the education is not real world and many companies want an employee who can start coding on day one, therefore only hire experienced coders. Just like with your nursing education, if you only spent time in classrooms, when you graduated you would not be ready to care for actual patients. No matter how well you did on exams and how great an instructor you had and how well you absorbed the study material, if you never actually set foot in an operating room, or touched a patient, or saw and touched instruments with your own 2 eyes, you would not do well as an OR nurse on day one.
3) I wish AAPC had a specific program/curriculum available for companies willing to hire CPC-As to use as a guide for training. Just like there is residency and internship for physicians.
As a nurse, your clinical knowledge likely far exceeds most other CPC-A coders. The piece you are missing is the insurance and administration type skills. I also realize remote work is far more popular now than it ever was. However, my personal belief is for a new coder, nothing beats onsite experience. Being able to turn to the next desk to ask a simple question, or even overhear other coders interacting will give you experience and knowledge much faster than remote.
Since you already work in a hospital setting, I would inquire about whether there is an onsite (or offsite) coding department or billing department. If there is, try to meet with a supervisor or manager from that department. Ask if you could come for an hour or two a week (or whatever you can spare on your own time) and sit with a coder. Bring them donuts. Try to sit with a coder at lunch. Make yourself known. For me personally, if someone from within my health system who already had computer access and security clearance and clinical knowledge and showed this type of initiative, I would absolutely consider them for my next open position.
If that's not possible where you are currently employed, then there's a pretty good chance you are going to need to take an even bigger paycut than you were expecting and try to find an entry level coding adjacent position. Billing. Registration. Front desk. Authorizations. Look for companies that do employ coders so you have the possibility to move into a coding position once you have a more rounded revenue cycle skill set. I believe the best coders have a decent billing knowledge and fully understand the entire revenue cycle. Companies do exist that hire coders with no experience, but the forum is littered with CPC-As complaining they cannot find a job.
Have a GREAT coverletter. Briefly explain you are making a career change and can't wait for this challenge. Emphasize your current skills that transfer to coding.
Network. Your current employer is a good place. Your local AAPC chapter is another. Linked in. Facebook. You just need one foot in the door opportunity.
Good luck!