I would recommend starting off in a larger 3rd party billing company. In order to be an effective coder it is essential to understand the fundamentals of the billing process as well. By working for a billing company you will generally have more opportunity to move around and work your way up rather quickly to obtain the knowledge needed to become a very effective coder. Most larger TPA's also have coding positions within and usually have very good continuing education which can be crucial for a new coder.
I started off coding within a physicians assistance division (essentially billing) of an international company which is now under the McKesson umbrella. I could not put a price on the experience and great training I received there.
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