There are still many reasons why physicians would outsource. The main reasons are costs of course, benefits, training, etc. Physicians are more apt to hire bilers than they are coders. If you are a certified coder along with having billing experience that's an added bonus. If you only have your degree, no certifications or actual experience it will be much harder for you to get your foot in the door. Some, like myself will argue that it's easier to market yourself as a business rather than looking to get into a position. Both are difficult to do without actual experience. You might want to look into certification to juice up your resume and add value to your marketing.