How to Prepare for a Pre-employment Coding Exam (2024)

Follow one coder’s journey from certification to dream job.

“There is nothing like the feeling of passing the CPC® certification,” I thought to myself the morning of Nov. 1, 2020, after receiving my Certified Professional Coder (CPC®) exam results. Anyone who has prepared for that exam understands the intense hours of education and study involved and what mental and emotional tolls it takes. But all that struggle melts away with the knowledge that you have been pronounced “certified.” Now, all I had to do was find a job. Easy, right?

Instead, I found myself applying to hundreds of jobs over the next few months, only to find that every employer was asking for prior experience. It is a conundrum that coders are painfully familiar with: How do you gain experience when no one will give you a job? It’s not easy, but it can be done.

Get a Job

I broadened my search to billing, medical records, medical receptio-nist, insurance, dental receptionist, and other similar fields — anything to break into healthcare. I eventually took a part-time job in dental insurance.

I was so afraid that I would find myself settling into just any old job in healthcare, and I would lose my drive and motivation to obtain a medical coding job. In an effort to stay connected to medical coding, I read Healthcare Business Monthly, got involved in my local chapter by becoming an officer, and listened to anything by Victoria Moll, CPC, CPMA, CRC, CPRC, AAPC Approved Instructor, AAPC Fellow, that I could find. Moll is on AAPC’s Chapter Association Board of Directors, a frequent contributor to blogs and podcasts, and a speaker.

Be Open to New Opportunities

After I had been at my dental insurance job for about a month and a half, I received a call from a coding manager at a local hospital. She was reaching out to see if I was still interested in a job in medical coding and, if I was, that she was offering a coding test. I just needed to call her to sign up for a slot. I felt my excitement beginning to mount, but since I knew so little about what the job entailed, I tried not to get my hopes up. I learned that the test would be offered in a week and covered ICD-10-CM and CPT®. It included multiple-choice and fill-in-the-blank questions, and I would be allowed two hours to finish the test. She reassured me that the coding scenarios were fairly brief, not long and detailed operative reports. Also, I could use my own books if I preferred. I told her I was very interested in taking the test, and we arranged to meet the following week.

I was practically shaking with excitement. I had mentally prepared myself for a year or two of gradually crossing over from dental into medical, perhaps working as a medical office worker and then moving into billing before finally being offered a position as a coder. Suddenly, I had been offered an avenue to the world I had so desperately been trying to break into. Here was a chance to prove that I was a proficient coder and would be a worthy applicant for this job.

Preparing for the Pre-employment Exam

Once I agreed to take the test, my mental gears started turning: How best could I prepare for the employment exam? While I had heard about interview exams from various articles, podcasts, and videos, I knew very little about how difficult this one would be. The only coding exams I had taken were multiple-choice format, which of course, requires a very different strategy than coding from scratch. For the CPC® practice exams and certification test, I started with the code selections in the answers and then used process of elimination to select the best choice as quickly as possible. With this employment exam, I would also be under a time limit, but I knew that the test would include scenarios that required looking up codes. I only had a week to prepare, so I needed an efficient strategy to prepare myself in a short amount of time.

5 Tips for Studying

I am excited to share my strategy in the hope that it will help somebody else who finds themselves in a similar position.

• TIP No. 1: Ask if the test is based on current year coding. It occurred to me that it was important that I find out if the test would include 2021 evaluation and management (E/M) guidelines or previous years’ guidelines, as this could totally change the scoring of E/M visits. In calling the coding manager to ask, I not only got the information I needed but also impressed on her that it was important to me to know how best to prepare for the exam.
• TIP No. 2: Utilize all of your previous training materials. I used all my AAPC training materials from when I took my CPC® preparation class, including the practice exams.
• TIP No. 3: Code from scratch. I dived back into AAPC curriculum and coded from scratch the short chapter quizzes. I worked through two or three chapters every day, covering the multiple-choice options, looking up the codes, and then checking the answers. It was tedious, but I started to gain more confidence as my skill improved and the various guidelines and potential coding traps started to come back to me.
• TIP No. 4: Re-take practice exams. I also took a CPC® practice exam each day leading up to the employment exam. I approached these exams the same way as the quizzes: I would code from scratch the multiple-choice answers and then compare my coding to the answers. This took a lot of time, but I became much more familiar with using the index in the CPT® code book, as well as the useful list of contents at the beginning of each chapter. I knew that in the real world of coding, these were the techniques I would be employing, so I had better get comfortable doing it this way!
• TIP No. 5: Use your own books (if permitted). I was so relieved to be able to use my own code books because they had all my notes from taking the CPC® exam. They brought a much-needed sense of calm and familiarity during the test.

It was a grueling six days, but I kept reminding myself that if I could just get through this employment exam, that would be the step I needed to get a job interview and, if all went well, a job offer in the field I wanted!

Exam Day

On the day of the exam, I arrived 10 minutes early, having already scouted out the location ahead of time. I met the coding manager and she reiterated the rules of the exam. I was placed in an isolated cubicle (which I was relieved about, as I was hoping not to be in a room full of other testers). The manager reminded me of the two-hour time limit and encouraged me to use as much of that time as I needed.

As it turned out, a good bit of the test was multiple choice. It was 25 questions, four pages long, and I progressed through the first three pages fairly quickly. I took my time to check, double-check, and triple-check my answers before moving on, but I found myself relaxing and feeling more comfortable as I proceeded. The last page was all coding from scratch and had some complex questions. I estimate that I took as much time on the last page of the test as the first three together. However, even with the challenges of the last page, I managed to finish in about half of the allotted time.

After I returned to the coding manager with my test, she graded it while I sat in the room, which was probably the most intimidating part of the interview! Luckily, I did very well and was finally at liberty to breathe a huge sigh of relief. I then had a brief interview with the manager and the coding team leader to learn more about the job. They were both very friendly and thorough regarding the description and requirements of the position, which sounded more and more like something I would not only be qualified to do, but also enjoy.

I was so emotional after everything was over that I was in tears when I got back to my car. I knew I had given it my all and done everything I could to prepare for the test. Walking away from it with the knowledge that I scored well, along with having the guarantee of a second interview, overwhelmed me with gratitude. To my surprise and great joy, I received an email later that day saying they had decided it was not necessary to conduct the second interview; they were offering me the job! In one day, I had taken the coding test, learned my results, had an interview, and received a job offer. They say good things take time, but great things happen all at once. That is exactly how I feel about that day.

Be Patient, Stay Motivated

I know there are coders out there who are certified and excited to take off in their first coding job, yet cannot seem to find a way to break into that first position. My advice to you is:

• Do not give up and settle for something less.
• Do not change your plans and dreams because you believe it is not going to happen for you.
• Keep trying!

Less than five months passed from the time I got certified to the time I got that phone call to come in for the employment test. Looking back on it now, it was not a long time; but as I was going through the disappointment of one rejection after another, it felt interminable.

Looking for a job can be very stressful, so it’s okay to step away for a time and rejuvenate. Just be sure to get back into the job search when you are ready. And even while taking a break, stay connected to the world of medical coding. There are so many videos, podcasts, blogs, and articles in which to immerse yourself. It is crucial, both for your own motivation as well as to keep your skills sharp, to stay connected to that lifeline.

Finally, if you do get a call for an interview and you need to prepare for a test, utilize the materials available to you. I had an amazing education through AAPC; and through them, I had every tool at my fingertips to help me confidently prepare for the employment test. I used those tools to my advantage and got a job that I absolutely love. For those of you reading this who have yet to break into medical coding, I hope the same will be true for you.