Breaking Into Medical Coding: How to Turn Externships into Careers

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It's time for the Contempo Coding Podcast.
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Discussions, knowledge and insight to help you succeed in the medical coding industry.
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And now here's your host, victoria.
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Hey everyone, Welcome back to the channel.
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I am here today with Corella Lumpkins.
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Corella has over 35 years of experience working in every area of the healthcare remedy cycle.
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She has her bachelor's degree in health service administration.
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She has an extensive background in auditing, coding, billing, compliance, cdi, denial management, education, practice management.
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She works very closely with providers and staff.
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She's a certified instructor for the AAPC and you teach the CPB curriculum and the CPC curriculum, and she is also an AAPC mentor, a Project Xtern host, which we will talk about.
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A lot about Project Xtern, I'm excited to talk about that.
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And you're president of the Leesburg Virginia chapter and you serve on the 2022 to 2025 National Advisory Board and I'm going to say the advisory board.
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This, this three-year term, has been amazing.
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I don't know that I've ever known the advisory board to be so passionately, oh, into the projects that they assigned us.
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There's been some I don't want to say the whole board, but like members, the Jets that I've seen in the past, where you don't hear from them, you don't have to do this year, like you know what everyone oh, no, oh, they're yeah, they're all yes, yes, yes, yes, yes.
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So yes, really, really.
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Just it was very invigorating.
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It's tiring.
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We did so much and I feel like we did so much and I know that's one of the things.
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I want the future boards to continue that momentum.
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So I think Rhonda's going to recruit a nice board.
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So take us a little bit back.
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How did you get into medical billing and coding?
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Well, I don't have the traditional story, you know, of getting into this field.
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I didn't know anything about medical billing and coding.
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But when I graduated from high school I didn't know what I wanted to do and so I did the Kelly Girl Services.
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I don't know, that's like, it's a temporary agency.
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It used to call Kelly Girl Services.
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His name is Kelly, I'm Kelly, I don't even know if they're still around.
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But I started taking a little temporary assignments and you know, at one of the times I was working at a doctor's office and so that's how I got into the healthcare revenue cycle, just as a medical records clerk at a physician's office, you know, and that working temporary.
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And so I took that and I started working in billing.
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And how I got into coding was, you know, I was coding before AAPC was even before we had an AAPC.
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Oh, okay, so I was coding back in 87.
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And so and I got into coding because I was working a temp job and I was working at a surgical billing office and I was at the copying machine copying EOBs to send out secondary claims, and our general surgery coder went into the office and put in her resignation.
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She had got a great job at UCLA Medical Center and so she was flabby.
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You know she was going to start this great life in California and she gave them like a two weeks notice.
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And so, while the director was panicked, came out the office right from the resignation, looked around the room I happened to be standing at the copy machine making copies and she said you come in, you're going to learn coding.
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And so that's kind of how I learned coding.
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We didn't have any.
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There wasn't an AAPC back then.
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We didn't have a lot of resources.
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I remember using like St Anthony's and some other little resources, but it wasn't really a lot out there because back then you were really homegrown.
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Was that back when the code books were almost like binders, where you would take out things and like put in the new pages?
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It was really really bad About that back in the day.
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Well, that was really bad.
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Everybody's done that.
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Not that quite that, but yeah, some some similar.
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I mean, if it was either before 1995-97 guidelines yeah came up you know.
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So uh, enms was leveled a whole lot differently.
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It wasn't like no real size actually.
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Um, yeah, to all a lot of that stuff.
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So that's kind of how I got the code and it from that.
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The love of that has taken me everywhere in this in this career field.
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Um worked in every type of facility the large ones, this was mom and pop, doc shop and uh, I've done every role and uh and uh it.
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It helps when you like.
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I think this is fun, so that helps.
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You know what I mean.
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That helps.
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How long did it take then, Like when did you start getting the certifications?
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I didn't get my first certification because I had been coding for years and back then it wasn't a requirement.
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You know now it's required.
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Then it wasn't a requirement and so you know I didn't really have an interest in certifications, quite honestly, when I first introduced them, and I think I had someone talk me into getting it in 2000.
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Someone said you've been coding for years now, have you ever thought about getting a certification?
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I was like no, not really, are you kind?
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of true, and I guess it convinced me about getting a certification.
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I was like no, not really.
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I was like what was that?
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It was true, yeah, yeah, I was like it's true and you know, and I guess it convinced me how it would put credibility behind what I already know.
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You already have the knowledge and the certifications will just put the credibility, and back then it wasn't like what it is now.
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We didn't have an apprentice credential.
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You know, we had the five hour.
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You know 150 questions.
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Yeah, that was graded in three parts.
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You know 50, 50, 50.
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And you had to get 100 in all.
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Every now and then I'll have people that will comment oh, you're so lucky because you've got five hours and 40 minutes.
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Oh man, but I had to answer 50.
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Oh yeah.
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Oh no, we had 150 questions, but we only had five hours.
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Oh, that's right.
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Yeah, because it was nine hours, and then I think it was 530 and it was 540.
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Yes, and then it went back to four, which is nice, because now it's not like a test of endurance.
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Yeah, and see you already had to have the letters of the years of it.
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You know you had to apply to sit for the exam, so you had to get your letters of employment, your references.
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You had to already have two years of working coding experience before they would even let you send for it back then.
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So so you know.
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So this change, you know, so again, that's, that's forever and it's changed and I can't say that I'm I'm upset about the changes because it's all brought in a whole bunch of new coders and brought a whole bunch of new activity into the industry.
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I think yeah, absolutely so.
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So, with over 30 years of experience and just having worked in such a variety of settings, what are some of the key things that have really helped shape your career?
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There's been a lot, first off, not being afraid.
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You know, a lot of times we get into these roles and then, if something else comes along, we feel like, oh man, I can't do that.
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I was lucky to have people see in me what I didn't see in me, type thing, you know.
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So I was always beingla you can do this, you can do this, you can do that.
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I'm like I don't think I could do.
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Oh, you can do this, you can do that.
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And so I had those people.
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And so if you have people like that, this encourages you.
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Um, but don't be afraid to take chances.
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You know I remember taking leaps, you know, uh, from uh, doing a clerk role to managing the practice.
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You know that was a huge leap for me.
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I remember the leap from doing billing and coding and then getting into auditing and further getting to compliance.
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All of those are leaps, if you will, but the foundation was there.
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If you have that good foundation, you can take this career everywhere.
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And I know I teach, so I'm always telling my students you don't just have to limit yourself to coding.
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This is just the foundation.
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You want that knowledge, because that knowledge is going to take you everywhere, from practice management to you know you might want to do BLM with you.
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You might want to do auditing compliance, you might want to teach.
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Yeah, and now we're getting so far into all of these technological advances that we have all these people that are like going out and getting the epic sour pop on all that, and then that opens a whole new world.
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yep, in the ai, all the ai certifications that's out there, or additional knowledge base, and training courses.
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Yeah, and it's always helpful when you said like you have someone who's willing to help you out and be like you're the best.
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But I also I also I'm going to confess, I'm just a little bit petty, so sometimes it helps me when people tell me I can't do it.
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Oh yeah, Because for a long time I was like they're like you don't want to work for providers, you can't do that, they're so horrible.
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And I'm like, oh, then let me show you.
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Let me show you, that would have motivated me too.
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That would have motivated me too.
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I had the opposite, though.
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I had a people that was pushing me, but that would have motivated me too.
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Yes, absolutely, but I think every everything was a step installed to something else and more responsibility.
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And then I found out that, um, once I had the director position and all this responsibility, I found out I didn't like that, and I found out that I actually liked a little smaller scale, not to manage as many people and to be more hands on.
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Yeah, and so now I have found this perfect role.
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I was in management for a while and I thought it was what I wanted.
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I'm like no, this isn't for me.
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I'm so like I want to be doing things projects and if I'm in meetings all day, I feel like I'm not getting anything done and I was a director in a big health system, so everything was a meeting or policy or committee or we had to pass, and I so like the fact that now they're like okay, we know we need to change business and I can just go and change.
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You know what I?
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mean so you've been doing a lot of teaching.
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Yes, in various settings it sounds, oh yeah, for higher education, I'm sure.
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Absolutely Teaching students.
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Yes, how do you kind of approach?
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Well, you know it's a totally different approach.
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You know I teach physicians all day long and so so I like to switch because, of course, it's a totally different approach to teaching.
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So, like some brand new student that just came from Walmart or Target and didn't learn coding, you know, if I teach them the way I teach my physicians, they're not going to understand, and if I teach my physicians like I'm sitting, they'll be like I'm in so many intelligence.
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You know what I mean.
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So, um, so I like the approach, I like being able to do that high level teaching with the physician and but also bring it down and break it down for maybe somebody brand new.
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So I love that aspect and and that's what excites me about teach up and teaching for like 25 years and teach it, yeah and then hopefully getting some of those students into your project.
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Oh, you are getting right here.
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Sorry about what I'm hearing talk on in project extra.
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How did you get involved into project extra?
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How did that fall on you?
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well it started with me running a school.
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That was one of my things along the revenue cycle was I found that I liked, I got into tj and then I was offered a role of can you help us develop an associate degree program in medical billing and coding?
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And so I was like, okay, so so I took that curve, if you will, I've also taken the curve on the payer side, if you will too.
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So I've done that as well.
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And so I made that pivot.
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And in teaching or running a school, I was also responsible for placing my graduates into helping them find employment.
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And that's kind of how I got into, found out about Project Xtern because it's difficult, you know.
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I was teaching students again coming from other industries that has no health care background whatsoever, you know.
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So they go through this course, they now have an associate's degree in medical building and coding and can't get a job, you know.
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And so that's when I really was like there's got to be something else out there.
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And so AAPC had just started a little known thing called Project Xtern, and they had big ideas around it.
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Yeah, but with the limited amount of sites employer sites that we have, that caused them to kind of cool off on it.
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I feel like there's definitely a dip period, because people were going on the site and they were looking for externships and there's like nothing there or they're like oh, there's one in Texas and one in Maryland and I'm in Minnesota.
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That's not going to help me at all.
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So there's one in Texas and one in Maryland and I'm in Minnesota.
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I was like, can I help me at all?
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Yes, yes, um.
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So so I like the fact that they are revitalizing it and I, I, I, I talk about it.
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You know, since I've been on this board, that's all they heard of.
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So I think they like.
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Okay, corrala, you know we're going to invest and try to get it.
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But you know I was like the main thing with Project XCert is not having enough host sites.
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So, and that's the problem is that most employers don't know about Project XCert.
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You're not vastly involved with AAPC, right, and it's kind of buried in AAPC even you know.
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So if you don't really have that knowledge that that program is there, um, you don't even know that it's available for you and I think one of the things we hear a lot from some of these larger health organizations that would probably very much benefit from project extern is we don't have time.
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Yes, we're busy running around our pants on fire.
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We can't possibly stop at any point in time and train people for internet extra shifts.
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The paperwork is too involved.
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So who is kind of the good organizations for this?
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Who's this project external best suited for and what's kind of involved?
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Well, one of the things that I was talking about in my session yesterday because I did a session on this is I talked about making this program individualized to your workplace.
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So if you have a busy workplace and you don't want to follow any one person, do the team approach at it.
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And I really look at with having new coders come in.
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They need the exposure period, they need to have some exposure regardless.
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So I let all my experts know you may not be coding, you may not be coding.
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That's something you have to tell your externs, because someone will think, oh, I'm coming, I'm getting this externship and I'm going to be doing all these operative report coding and all this and I'm like, no, you might be just pulling records, you might be just doing EOB scanning or you might be.
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Whatever the point of it is is that you are here doing the practical application of it is is that you are here doing the practical application of it and you're working with codes, regardless of if you're assigning them or not.
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You know you do.
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We do a lot of abstraction.
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I give a lot of my externs abstractions because I manage the ACO and so we have to do all these quality submissions and supplemental files and you know and of course, keep up with HEDIS metrics and all of that stuff, and the externals are great at teaching them how to do those things.
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You know, my thing is leave your more skilled workers to do the more skilled or the higher level things and the more menial stuff I mean.
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Sure, if you go to every one of your employees and say, what do you hate doing, they will tell you something that they hate doing that we could train the extern to do Well.
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I think a good thing that would be excellent for some of these externs is we're seeing so much activity from the racks, the ZPIC, the TPE, yes.
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And what's the first step in the TPE?
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They need to pull the records, yes.
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Why are we wasting coder time?
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Absolutely, someone the records.
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Yes, why are we wasting coder types, the loan records, absolutely.
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Next turn pull the record channel someone double check that absolutely and and then you know, with risk adjustment, they want the whole year.
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We want the whole year of services for 1800 patients.
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You know, yeah, so, yes, you know, and and uh.
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So I'm a true believer in um exposing and, again, getting that experience on a resume for an extern is key, you know, once they put on.
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I've had externs that came from Burger King, took a coding course, got an externship, was on an extern for two weeks and immediately was picked up.
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I have so many success stories.
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99% of all my externs are employed in this field right now and it's a win-win.
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I mean, I don't get it.
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I don't understand why people don't want to do it and I think it's just about spreading the word.
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Yeah, and I think, unlike some of the I know some of the HEMA certificates, like the RHIT, yeah, certain programs that you have to go to, yes, but this isn't as small as that.
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There's no checking off the boxes, filling the paperwork out and filing no, and it sounds like it's flexible as well.
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It's very flexible.
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So you're like you know what?
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We only need someone for like two days.
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Absolutely.
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I've had exters only come in and work one day every two weeks for four hours, you know, and you want to make it flexible for the exter because they're giving away their volunteer time.
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This is a volunteer, unpaid service, you know.
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And so I've had the exter that treated like it's a full time, monday through Friday, very committed to a job.
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And then I've had the exter like, look, I can't afford to come that often.
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So, you know, can I just come in these couple of days and make it flexible?
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Yeah, and whenever they come in, whether they're giving you two hours or a whole day, there's something to find for them to do and I'm sure the first time you take on an extern there might be some upfront work.
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Ok, we have to make sure we figure out how do we get hit the clearance and sign them up for whatever security system, definitely.
00:18:20.340 --> 00:18:26.325
But once you kind of got it down and protocols, then the next one comes in and you're like, oh, this is what we did last time, so it yeah that's it.
00:18:26.365 --> 00:18:28.151
There are some considerations you got to take.
00:18:28.151 --> 00:18:29.673
Yeah, you want to take waivers.
00:18:29.673 --> 00:18:39.529
You want to make sure that you get a waiver because you don't want to be responsible, like if they get hurt or anything happens to them because they're not an employee of your company.
00:18:39.529 --> 00:18:45.009
Yeah, um, and you know, and in bigger facilities I used to tap into the volunteer services.
00:18:45.009 --> 00:18:50.362
Every big facility have, uh, you know, elderly come in to work your front desk and what.
00:18:50.362 --> 00:19:00.211
So we would just tap that into the volunteer services, that huge organizations and, again, mom and pop doc shops, when you're the only billing person for the whole practice.
00:19:00.211 --> 00:19:04.800
Yeah, there's a lot of work that you do that you can pawn off on the x turn.
00:19:04.881 --> 00:19:09.096
Yeah, you know yes, so it sounds like you're.
00:19:09.096 --> 00:19:10.681
You've got a lot on the plate right now.
00:19:10.681 --> 00:19:11.281
You've got work.
00:19:11.281 --> 00:19:12.413
You've got project x turn.
00:19:12.413 --> 00:19:13.095
You've got the nav.
00:19:13.095 --> 00:19:14.578
You still got a few more months to go on there.
00:19:14.759 --> 00:19:14.941
Yeah.
00:19:15.109 --> 00:19:20.442
So what do you kind of do outside of that to help invigorate your personal life?
00:19:20.442 --> 00:19:25.721
Yes, rest and recharge so that you have the motivation to go out the rest of it.
00:19:26.109 --> 00:19:27.411
I love concerts.
00:19:27.411 --> 00:19:29.011
Oh really, concerts are work.
00:19:29.011 --> 00:19:29.451
Yes, so, yes.
00:19:29.451 --> 00:19:31.232
So I've gone to.
00:19:31.232 --> 00:19:33.173
You know all of my favorites.
00:19:33.173 --> 00:19:37.154
You know I just went to see Janet Jackson, not to see Blah Blah Go.
00:19:37.154 --> 00:19:38.756
So all of my favorites.
00:19:38.756 --> 00:19:41.057
Usher, you know all of my favorites.
00:19:41.057 --> 00:19:49.441
I've gone and see what everyone is touring this year, from Taylor to, from everyone else.
00:19:49.441 --> 00:19:53.963
I know I think it was last year at the DC Regionals.
00:19:53.963 --> 00:19:56.025
I think I attended Beyonce's concert.
00:19:56.125 --> 00:19:59.365
Oh, yeah, I remember one of my friends went to go see Pink or something.
00:19:59.365 --> 00:20:02.327
Yeah, I remember when you were saying yes, yeah.
00:20:02.347 --> 00:20:04.248
so I love to do that and I love to dance.
00:20:04.248 --> 00:20:08.695
So me and Roswell, we like to go out.
00:20:08.715 --> 00:20:19.313
So you've only got a few more months left on the National Advisory Board and again it's just been such a busy board.
00:20:19.333 --> 00:20:21.539
What are your kind of hopes for the next chapter of the advisory board?
00:20:21.539 --> 00:20:24.067
Well, I definitely want them to continue all of the efforts that we've started.
00:20:24.067 --> 00:20:31.050
When you join the board, you kind of pick up where the last board ended, so a lot of the initiatives were already there.
00:20:31.050 --> 00:20:33.214
We just expanded on them more.
00:20:33.214 --> 00:20:49.041
But then we created other things, you know, and the Merger Leaders Program, and we really expanded our mentorship city and our mentor programs and we were looking to look for things for career advancement.
00:20:49.369 --> 00:20:52.231
Like you know, we really wanted to focus on and I'm hoping the next board can continue that.
00:20:52.231 --> 00:21:01.759
Like you know, we really wanted to focus on and I'm hoping the next work can continue that or focus on the steps that you need to take to become a coder, the steps you need to take to go from coding to auditing.
00:21:01.759 --> 00:21:04.480
Maybe you want to go from auditing to compliance.
00:21:04.480 --> 00:21:20.337
You know, compliance to teaching, or what have you to kind of have like a pathway if you will set up for those roles that people want to go into, and so I'm hoping that they are able to expand on that even more.
00:21:20.337 --> 00:21:24.556
We kind of started the process and that's one of the things we're going to kind of roll over into the next board.
00:21:24.556 --> 00:21:27.210
So I'm hoping that they expand on a lot of those different.
00:21:27.390 --> 00:21:29.731
And I'm sure there's going to be a really good transition there.
00:21:29.731 --> 00:21:31.073
Yeah, really good energy.
00:21:31.073 --> 00:21:38.720
Oh yeah, make sure that there's a good continuation of everything that's been going with the past three years, more than absolutely excellent They've been doing.
00:21:38.720 --> 00:21:42.222
Where can my viewers find out more about you and about Project Xtern?
00:21:42.903 --> 00:21:43.944
Well, Project Xtern.
00:21:43.944 --> 00:21:53.479
Aapc has some resources out there but to be quite honest, I'm again trying to get them to push it out there.
00:21:53.539 --> 00:22:12.954
They are hesitant a little bit again because we'll have a lot of people sign up for and then they don't want to be like we can't meet me, as if I Facebook going I found that yeah yes, and you know that blasted us because we don't have enough sites out there, right, you know, and so they, you know, so they try to take it, you it a little step at a time with it.
00:22:12.954 --> 00:22:29.007
But I'm on LinkedIn so any viewers can definitely get in contact with me there and I'm definitely free to share my email address because I'll answer any questions about it to help people get started on it.
00:22:29.007 --> 00:22:38.189
And I'm hoping that it grows and it grows to the point where then AACC can really start blasting it because we'll have enough sites to accommodate anybody that wants it.
00:22:39.440 --> 00:22:44.256
I'm going to leave in the comments a link to Pharrell's LinkedIn, as well as Project Xtern of the AACC.
00:22:44.256 --> 00:22:45.171
Definitely go and check it out.
00:22:45.171 --> 00:22:45.752
Thank you, guys.
00:22:45.752 --> 00:22:47.353
I will see you in the next video.
00:22:47.353 --> 00:22:48.844
Until then, keep on coding.