Cultivating the right mindset, values will take you far in HIM (and life)

By Ken Macklem, RHIT, CCS

My career in healthcare started in the medical records department, filing paper. I loved it, and that led me to abstracting labs for the coding department. I took a coding class at Mt. Saint Mary’s (this was in the pre-credential days) and learned CPT and ICD-9 by the book, before encoders.

Today I’m the Vice President of Coding and Managed Services for Norwood. And have had a dozen notable stops between, including VP of Business Development and Strategy for iCodify, VP at Miramed, and Director of Coding at UCLA Health System.

I had the opportunity to tell my story to about 20 students and new HIM professionals on a recent Zoom call hosted by Felicia Thomas. I told them what I’ll tell you today: If you pay your dues, be patient, and work your way up, the rewards of the HIM profession are great.

More than landing a first perfect job, or getting a great referral, if you inculcate the following values they will take you far:

• Work ethic
• Humility
• Going above and beyond
• Building a network
• Self-advocacy

The first four speak for themselves (although they are easier said than done). Show up early and work hard. Do more than your manager expects. Understand that they have had experiences and knowledge that you don’t. Know that you will make mistakes (and get better from them). Surround yourself with good people who support and encourage you, but aren’t afraid to give you honest feedback.

Self-advocacy needs a little more explanation. No one is going to plan your career better than you, no one is going to advocate on your behalf as much as you. Sometimes we get into a habit of going to work and believing that our employer will plan and manage our promotions and path, and spoon-feed us the tools we need to grow.

But that’s not how it works. Most successful people start from the ground up and communicate their desires. If you want to be a manager, communicate that, ask those questions.

I took my first step out of coding and into management in 1997, and ended up becoming coding supervisor, then assistant director of that department—before I got my RHIT—because I told my boss I want to do more. She was like, “OK, let’s go!”

Don’t go in and expect the world. Work hard, do your job, but advocate for yourself, and take ownership of your career path.

Pick where you want to work, whether that’s for a physician group, or a hospital, coding, or nursing. And know that you’ll have choices—from HIM you can go into nursing, CDI, technology, education, or systems management.

I ultimatley had many choices. I taught a CPC curriculum for the AAPC. I worked for a company that created revenue cycle departments—from authorization, to coding and charging, to contracting. I managed denials for UCLA. I implemented CDI at Cedar’s Sinai Medical Center.

But you have to start at the ground level. Be humble, work hard, and be a self-advocate.

If you’re just getting started, here’s a few tips:

• Put together your resume now.
• Reach out to a recruiter. Recruiters are supportive and encouraging, but can also look at what you need, what you’re missing, and tell you how modify your resume to be more attractive to clients. And it’s a connection you’ll always have.
• Get your coding credentials. Looking back, I’ve been blessed and fortunate, and my career went how it needed to go for me. But I probably would have gotten my credentials sooner. I put off getting my CCS (it was back in the day when you tested with paper records). I would have gotten my RHIT sooner, but to be honest I was afraid of failing, and I let my failure push it off. When it became a necessity, I did it. So get your credentials as soon as you can.