One argument presented for starting with physician office coding is the fact that in a hospital, a coder is not exposed to the ancillary departments as the front desk and back office billing in a hospital setting like they are in a physician office setting. The billing, business office and patient accounts as well as the admissions/registration areas are in separate locations of the hospital from the coding department. And typically, the coders are not involved with those functions---they only code.
However, I worked in a hospital and my experience was that there was still some interaction between the coding department and the billing or other staff via phone or in person. For example, many times the billing manager or patient accounts rep would come down to the coding department to discuss issues or they would email or call to that department regarding denials, coverage issues, missed charges, and so forth. I recall one case that the assistant manager had me handle when I volunteered at my local hospital. Billing had called down to our department because they wanted to know if a charge could be assigned for a foreign body removal, because the coder had not assigned a code for it. So although, the exposure may be limited, in a hospital where the reimbursement is handled as a team with multi-departmental interaction, in my view, a coder can still get a view of billing, especially from the standpoint of how coding practices affect billing and reimbursement.
But here is an alternative: start working in the hospital billing or patient accounts department, work there for a while to get familiar with back-end billing issues as a way to get your foot in the door and then when a coding position comes open, move on into actual coding.
Check out this post too for more information on the challenges of hospital billing and coding: http://medicalassociationofbillers.yuku.com/reply/14794#reply-14794
Christina Benjamin
Independent Coding & Education Consultant
Email: cmbenjamin@bellsouth.net
www.tools4coding.com