Embarking on a new career path in medical billing and coding can be both exciting and daunting.
As you stand on the threshold of this important healthcare sector, it’s essential to prepare effectively for your upcoming interviews.
This guide is designed to arm you with a well-rounded set of sample interview questions and answers tailored to entry-level positions in medical billing and coding.
Whether you’re a fresh graduate or making a career switch, our guide aims to build upon your knowledge base and experiences, presenting you as a passionate and skilled candidate ready to take on your new role.
Entry Level Medical Billing and Coding Interview Questions and Answers
What is medical billing and coding?
Medical billing and coding is the process of translating healthcare services into universally understood codes for documentation, billing, and insurance claims. Medical coders assign specific codes to diagnoses and procedures, while medical billers use those codes to create insurance claims and bills for patients.
Why did you choose a career in medical billing and coding?
I chose a career in medical billing and coding because it combines my interest in healthcare with my attention to detail and organizational skills. I enjoy working with data and appreciate the critical role this field plays in ensuring proper patient care and efficient healthcare services.
Can you explain the difference between ICD-10-CM and CPT codes?
ICD-10-CM codes are used for diagnosing diseases and health conditions, while CPT codes are used to describe medical, surgical, and diagnostic services. ICD-10-CM codes are primarily for patient diagnosis, whereas CPT codes detail the medical procedures performed.
What is a superbill?
A superbill is a detailed document used by healthcare providers to capture all the information necessary to create an insurance claim. It includes provider information, patient information, a list of services provided, diagnosis codes, and procedure codes.
What steps would you take if a claim is denied?
If a claim is denied, I would first investigate the reason for the denial by reviewing the explanation of benefits (EOB) and cross-referencing with the patient’s records. Next, I would correct any errors and submit an appeal if appropriate. Communication with the insurance company may also be necessary to resolve the issue.
How do you stay current with changes in medical coding and billing regulations?
I stay current by subscribing to industry newsletters, joining professional organizations such as the American Academy of Professional Coders (AAPC), attending webinars, and participating in continuing education courses.
Describe your experience with electronic health records (EHR) systems.
I have experience working with several EHR systems, where I was responsible for entering patient information, coding diagnoses and procedures, and generating billing reports. My proficiency includes navigating the system, ensuring accuracy, and maintaining data security.
What steps do you take to ensure data accuracy and compliance in your work?
I ensure data accuracy and compliance by double-checking codes against medical records, using up-to-date coding manuals, following industry guidelines, and staying informed on regulatory changes. Regular audits and cross-checks help maintain high standards of accuracy.
How do you handle confidential patient information?
I handle confidential patient information by adhering to HIPAA regulations, ensuring that all data is stored securely, and only sharing information with authorized personnel. I also use secure methods for transmitting patient information electronically.
How do you prioritize your tasks when handling a high volume of claims?
I prioritize my tasks by first addressing high-priority claims, such as those with approaching submission deadlines or those flagged as urgent. I also break down larger tasks into smaller, manageable steps and use organizational tools like to-do lists and scheduling software to keep track of my workload.
What coding systems are you familiar with?
I am familiar with ICD-10-CM, CPT, and HCPCS coding systems. I have experience using these codes for documenting diagnoses, medical procedures, and billing purposes.
How would you handle a situation where there is a discrepancy in a patient’s record?
I would investigate the discrepancy by reviewing the patient’s record thoroughly, consulting with the healthcare provider, and cross-referencing any related documents. Once identified, I would make the necessary corrections and document the changes.
What is the importance of medical necessity in coding?
Medical necessity is crucial because it justifies the use of specific services and procedures for treating a patient’s condition. Proper documentation ensures that the health services provided are covered by insurance and are deemed necessary for the patient’s treatment.
Describe a time when you encountered a difficult coding situation and how you resolved it.
In a previous role, I encountered a case with multiple diagnoses that required careful sequencing. I reviewed the patient’s medical record, consulted with the healthcare provider to understand the treatment plan, and checked the latest coding guidelines to ensure accurate and compliant coding.
What software tools have you used in medical billing and coding?
I have used several software tools, including EHR systems like Epic and Cerner, billing software like Kareo and NextGen, and coding tools like EncoderPro and ICD-10 coding books.
Can you explain what HCPCS codes are?
HCPCS codes are used to describe healthcare procedures, services, products, and supplies not covered by CPT codes. These codes are important for billing purposes, particularly for services outside the scope of standard physician care.
How do you handle rejected claims?
I handle rejected claims by first identifying the reason for rejection, correcting any errors, and resubmitting the claim after thorough verification. Communication with insurance companies and healthcare providers may also be necessary to resolve issues.
How do you manage time-sensitive tasks, like claim submissions?
I manage time-sensitive tasks by planning ahead, setting clear priorities, and using tools like reminders and calendars to keep track of deadlines. I make sure that all necessary documentation is completed promptly to avoid delays.
What strategies do you use to minimize coding errors?
To minimize coding errors, I use a variety of strategies including double-checking my work, using updated coding manuals, performing regular audits, and seeking clarification from healthcare providers when necessary.
How do you ensure effective communication with healthcare providers and insurance companies?
I ensure effective communication by being clear and concise in my interactions, using professional language, and actively listening to understand concerns and requirements. I also document all communications for future reference and follow up as needed.