Wiki second coding job ever...might be a big challenge.


Richmond, VA
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I'm looking for advice here more than anything else.

I'm an established coding professional; I've been working for a home health company as the sole coding specialist in my area network, for about 2.5 years. I am responsible for coding a census that varies from 200-360; I review the OASIS documentation but my primary responsibility is the ICD-10 diagnosis coding, and I have a reputation as being one of the best coders for my employer, for the region in which I work.

Due to reorganization in my current place of employment that will affect my job heavily in a negative way, I updated my resume and was pounced on pretty quickly! I am looking at a very nice job offer for full-time (hourly, with overtime as needed), making a considerably higher pay rate than my current job, complete with benefits that are equal to or better than what I have. The only downside is the commute is much greater, but I'm not concerned about that.

What I am a little concerned about is that once again I would be the sole coding specialist, and this company has previous outsourced all of its coding to another company. They want to bring it in-house because they're growing and want to do as much of their own work in house as possible going forward. They also feel an in-house coder will have a greater investment and possibly input for documentation improvement, strategic vision, etc. I feel like this is a tremendous opportunity to get my foot in the door of a company that's going places, that I can grow with professionally and have real influence on. On the other hand, they have no experience having their own in-house coder and may have some unrealistic expectations.

What do you think? Am I setting myself up for trouble? Is there some hidden catch I may have missed? Or is this just an amazing stroke of luck I should grab before it slips through my fingers?
That's quite the dilemma! I won't presume to speak to the coding career aspects of this decision, but I do have 2 cents to offer in respect to changing jobs. Over the last 30-ish years in the workforce, I've made several career moves and I had two thoughts when I read your post:

1) A great job is less about WHAT you do than WHO you do it with. Being able to "enjoy" going to work each day is huge. Will you enjoy the people you'll be working with? Will you enjoy what you're doing? Do you like big challenges? Personally, I enjoy coming into a mess and cleaning it up. You mentioned a longer commute and the possibility of "unrealistic expectations" ... 6 months from now will you be hating that long drive and having to deal with a meddling manager? No amount of money is worth being miserable ... on the other hand, you are an established coder and "was pounced on pretty quickly" so you could ride this gravy train as long as it lasts and if it all goes sideways you can move on again then.

2) It takes time to build trust. When I first made the transition into the medical field I needed someone to take a chance on me and my unique resume. It was a risk or gamble on their part (would I work out?) and mine (would I like it?). SCORE! As they got to know me and my attention to detail I became entrusted with more and more. I've earned their respect and have, as you said, been able to "grow with professionally and have real influence on" the practice. Each time you change jobs you have to go through this period of proving yourself again. But as they see what you can do and that they can trust you to look out for the best interest of the business ... that's when your voice starts carrying weight (unless of course you work for a micro-manager that can't see the gold mine they have working for them).

So ... what I always end up doing is imagining where I'll be a year or two from now. Will you be dragging yourself through yet another dreaded commute or will you be so eager to get to work because you are now the captain of your own ship - your opinion carries weight and everything in the coding department is running smoothly because you're calling the shots and your entire staff (which consists of you) does everything your way. ;)

I hope some career coders chime in to help you out. I don't envy your decision. Best of luck!
I would suggest you take a chance and go for the end of the day these are always chances. Nothing is set in stone but what I would say is all those really, really successful people have 'gone for it' several times in their life. A friend of mine in England decided to go for it in the early 1980's. He went from being a hairdresser to selling pharmaceuticals to starting his own company dealing in disposables, things like razor blades, toilet rolls and the like. Sold the business about 6 years ago for $100 million..... he could still be selling pharmaceuticals and getting a good paycheck. He took a risk. Are you the risk-taking kind? I'm not but if you are.....?

No, things don't always turn out for the best but, down the line, when you've gone as far as you can working where you are now, you may wish you'd taken the plunge and introduced some new challenges into your work life. It is true that if you are in a position where there are no challenges and you feel comfortable, you will not achieve anything other than a paycheck.

I would definitely do as much research as you can on the new company.... talk to them. Ask them where are they going, what is their vision for the future, what are their expectations of you, and where do they see you in 5 years. Review them on Glassdoor. Although not foolproof, it may give you insight into what current and past employees think of the company. If they only get 1 or 2 star reviews I wouldn't give them the time of day.

Best of luck. Let us know what you decided.
Thank you all for your thoughts!

Believe it or not, I hadn't thought of it in the context of putting myself out there and risk-taking, but that helps a lot. I do tend to be very cautious in my career, because it does take a while to get your foot in the door as a coder and I would hate to lose the progress I've made toward my long term goals (of course, long term goals do change, too). A challenge would be a good thing for me, for sure.

The point about appreciating who you work with is well-taken, too! I actually interviewed with the director of finance and the CEO for the company, and I couldn't get the best read on the finance director, but I actually really liked the CEO. He was direct and straightforward, didn't mince words, and he was watching me for cues. I think what sold them on me was largely my enthusiasm for the profession, which is probably legit my greatest professional strength--I am a coding nerd, and I'm passionate about data integrity to a degree that seems to surprise people.

I've heard a couple different reviews on this company from nurses who have worked there, and they're mixed reviews, but I'm not sure the perspective is the same between clinicians in the field versus quality review staff. Still, I think I will double check with the one I know best and get her thoughts.

I went ahead and accepted the job. Thank you all so much for your input! I really appreciate it.