I wish you good luck on your exam. I think you definitely have an advantage over most other new coders.
Use your insurance experience to it's fullest extent. Most payers hire coders, and I would take advantage of this in order to get some hands-on coding experience. It might be easier to start out by "going back", so to speak. Insurance experience will be extremely helpful for your long-term goals, particularly if you wish to work independently.
Once you have a year or two of coding experience, you'll be in a better place to secure employment within a health care facility, but as you send out your resumes in October, I'd still apply at medical facilities and mention your insurance experience. In other words, don't limit yourself. There's no 'right' way to get into coding, and many of us didn't necessarily take a direct approach.
If you wish to work independently, and/or have your own business, you'll need several years of experience in multiple specialties. I think one of the misconceptions of new coders is that that once you've taken the community college courses and passed your CPC, you are now qualified to code anywhere and for anyone. You could work towards that goal by positioning yourself in a multi-specialty practice or a hospital-owned physician group, and plan to spend some time learning all you can.
If you do decide to teach, consult or code remotely someday, it might be helpful to get an undergraduate degree (or at least some courses) in education or business, with a focus on teaching adults. In order to be a successful teacher, you must know your subject matter inside and out, so it will be important to have a solid understanding of, and then always stay up on the many changes in CPT, ICD-9 (and 10), CMS and with the commercial payers both locally and nationwide.
Another misconception about coding is that a degree is not required. I can tell you that my facility has raised the bar significantly over the past few years, and it won't be long before a degree is a pre-requisite. My job requires a BS or BA, and there are days when I wish I had a law degree! All of my coding staff is strongly encouraged to have (or be working on) an Associate's degree. If you run your own business, a business degree is highly recommended.
I hope this is helpful. Best of luck to you.
Pam Brooks, MHA, CPC, PCS, COC
Dover, NH 03820
If you can dream it, you can do it. Walt Disney