This week’s spotlight features a physical therapist who works as a medical coding specialist!
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What is your full name, title, and company name for your current, primary role?
Jill Prenger, DPT, CPC-A – Medical Coding Specialist-Certified for University of Missouri-Columbia University Physicians
What additional roles do you currently have?
I’m the Treasurer for the local AAPC (American Academy of Professional Coders).
Where are you located?
Jefferson City, Missouri
Where did you go to PT school, and what year did you graduate?
I graduated from Saint Louis University in 1994 with a Bachelor’s degree in Physical Therapy, and earned a Doctorate of Physical Therapy from Boston University in 2006.
What did you do when you first finished school, and for how long?
I worked as a PT in an acute care hospital, working in outpatient, acute care, wound care, rehab, and SNF for about 2 years. Being a small town hospital, we did everything–sometimes all within the same day.
I stayed primarily in acute care and SNF for 24 years after that.
Did you enjoy those early roles?
I really loved what I did. However, in a small hospital (120 beds), sometimes you get to know people too well and it becomes a clique type situation.
What else have you done since then, prior to becoming a certified medical coding specialist?
I was Manager of Physical Therapy at a large hospital in Virginia (350 beds), where I managed me (the only PT, in ortho, acute care, psych, wound care), 4 PTAs and 5 techs for two years.
I also did travel PT for two years in the same settings. I ended up working in another 350 bed hospital doing all of the above, but not as the only PT!
When and why did you decide to do something non-clinical?
I started thinking about non-clinical about eleven years ago when my physical health started to decline. I was tired of the productivity standards being used in a human-based care system (when people became units).
Then, I had my first back surgery in 2012. I was able to return, but had my second surgery in 2019. My surgeon didn’t OK my return to PT in any form unless I wanted to schedule my next surgery then, as he felt people were getting heavier and less able to help. That prompted me to look in to other options.
What are you doing these days?
I am a Certified Professional Coder for the surgery departments of a 650 physician university-owned (Mizzou-rah!) clinical practice. I currently code for five surgical specialties and am on track to add two more. I also code evaluation and management coding of in office procedures for four physician groups and nine providers.
Are you still treating patients, or are you solely non-clinical?
I’m all non-clinical.
How long have you been in your current role?
About 15 months.
Did you get any special certifications or training along the way to help you become a medical coding specialist?
To become a medical coder, I had to pass a certification exam (boards) from the AAPC (American Academy of Professional Coders). I took the self-study program through the organization (the best path for success) while I was on disability from my back surgery.
How did you find your job? Did you apply or find it through a connection?
I applied for at least 30 jobs, using the skills I learned in Non-Clinical 101.
I got offered a job at my ortho surgeon’s clinic (another large group practice) with a reference from him, but I had just accepted my current job.
Did you do anything special to your resume and cover letter to land the job?
I tailored my resume to contain the language that each job advertisement used. This is a great way to get through the computer screening process (thanks Non-Clinical 101!).
I made sure I emphasized my love of learning new things and my ability to learn quickly! I also had a lot of guidance from my advisor through my disability insurance company.
Side note: MAJOR ADVICE–Get disability insurance even if you are healthy!
How have people reacted to you leaving patient care?
Really well actually! The people who matter knew that this wasn’t necessarily my decision. They were proud of me for not staying on disability when I knew I was able to do other work, because some people don’t have that ability.
But even the people who knew I was questioning the field were supportive.
Most of my former co-workers have told me I look so much happier now!
What’s a typical day or week in the life like for you as a medical coding specialist?
I have certain physicians and clinics I’m responsible for coding. This involves three different coding systems to accomplish: the coding system, the charting system, and the editing system.
I make sure that my Teams and Outlook notifications are on, of course. I’m 100% remote so these are vital.
Code all of the notes I have, then start on the editing system, catching the errors I made before they go to billing. When insurance companies decline initial charges, I need to figure out why, fix the issue, and send it back through our billing system.
Then, I have to double check on charges that may have been missed by other coders or by the computer, and charges that were missed by the inpatient coders (it sounds way more difficult than it is!).
What are some of the rewards of your role? What are the biggest challenges?
The biggest reward is that my commute is only ten steps away! Other rewards are knowing that I did a good job, and bonuses based on the performance of the physician group. The reason for that is that there is no revenue without proper coding.
The biggest challenge is not being confident in the codes I choose to bill, which relates to my efficiency–this matters more than productivity right now. My bosses are great, and monitor my accuracy every quarter or every new specialty I code.
How did your clinical background prepare you for being a medical coding specialist?
I’m using all of the medical knowledge that I had as a PT, with a bonus for knowing how the surgeries are performed. This makes interpreting the doctors’ notes and discussions with the doctors easier.
Of course, I think half of the abbreviations they use are not on the approval list, but Dr. Google helps with that. 🙂
My decision making skills, and ability to focus on small details and see the greater picture has helped as well.
Roughly speaking, how are the hours and pay compared to patient care?
The hours are great! I can start and end the day when I want, or take breaks for appointments as needed, as long as I get my 40 hours in. Days off have to be approved, of course.
I’m making $25 per hour plus overtime, paid holidays, great rate for earning vacation and sick time (separate banks), and no weekends. The benefits more than make up for the salary!
What type of person do you think would do well as a medical coding specialist?
You have to be very detail-oriented. Knowledge of surgical and medical procedures is helpful when communicating documentation needs to physicians.
Be willing to learn something new every day, as the insurance/Medicare regulations seem to be quite fluid.
You must have patience/tolerance with all computer issues, especially being your own IT with remote work. Self-direction and independence are important, but you are still part of a team.
Do you work remotely or onsite?
Does your organization hire PT, OT, or SLP professionals into non-clinical roles? If so, what type of roles?
A lot of medical coders are former nurses, even physicians, so anyone that has medical knowledge will have an easier time catching on.
Did you take any courses, or do anything special overall to get you where you are today?
Non-Clinical 101 was extremely helpful. 🙂
I also took the self-study course from AAPC, and participated in their Facebook group as well as the local chapter.
What is a typical career path for a medical coding specialist?
There are so many options: Health Information Manager, MBA, insurance companies, auditing, compliance, management (of course), documentation specialist.
There are a lot more, but these are the things I’m interested in (except management–that’s not my thing!).
What is next for you? What are your high-level career aspirations?
RIght now, I just want to be at a point where I feel like I know what I’m doing :). I really can’t think past that yet.
I think I’m leaning toward the compliance and auditing areas, several years from now.
What would you recommend to someone who is considering going into a medical coding role like yours?
Find someone that is already doing what you want to do and ask them about it. If you decide to go into coding, the very best route is the self study course from AAPC. It has the highest pass rate of all of the options in my observation.
The Board Certification is through AAPC, so you will be involved with them at some point. Patience is very important–especially patience with yourself. It’s a difficult subject area.
What would you like to change most in the PT profession?
I would like to see the pressures of productivity decrease. I always wanted to be able to spend more time with patients and connect more with them, which is difficult to do in acute care. The amount of documentation won’t decrease (I promise), so we need more time to document what the insurance companies require and to be thorough enough to get maximum payment.
I’d definitely like to see direct access able to be utilized in all states for the patient’s benefits.
What career advice would you give yourself that you wish you had during school?
That there are options.