Medical billing and coding activities are an integral part of a healthcare facility’s everyday work.
People who work in medical billing hold administrative jobs and enjoy a regular income with daytime working hours.
This job is excellent for people who want to work in the healthcare industry but do not want to spend long years studying.
People working in this capacity have a lot to do in terms of paperwork and typing.
They sort out data and perform data entry duties and also manage telephone calls, especially to insurance companies.
This job requires employees to be very professional as a lot of very confidential data is exposed to them and it is up to them to ensure that no information leaks.
If you are hiring (or even looking for a job) in this capacity, the following questions and answers may help you while taking/giving an interview for this position:
- 1. What certifications do you hold?
- 2. Have you performed billing activities for Medicaid or Medicare? How was your experience?
- 3. How do you manage rejected or unpaid claims?
- 4. Have you billed or coded for any specialties?
- 5. Which forms have you most often used in your current and former positions?
- 6. Does your current employer use EMR or EHR?
- 7. Which type of software have you used: Epic, Medisoft or other programs?
- 8. Do you have medical-billing certification? If not, are you planning to get certified or are you in the process of getting certified?
- 9. How do you keep current with insurance and health care coverage changes?
- 10. How long does it take you to process one day’s worth of patient visits or claims?
- 11. Tell me about the last claim you had denied. What happened, and how did you resolve it?
- 12. What’s your strategy and process for appealing a denied claim?
- 13. Tell me about your most hostile patient-collection case. What was the problem you encountered? Were you able to negotiate payment?
- 14. Do you think insurance companies sometimes play games to see if they can avoid paying claims?
- 15. What’s your understanding of medical terminology?
- 16. Have you billed for Medicare and Medicaid?
- 17. How do you deal with rejected or unpaid claims?
- 18. Are you comfortable working with computers? What types of software do you have experience with?
- 19. Do you know how to submit claims to a clearinghouse? Have you ever set up a provider with a clearinghouse or resolved claim submittal issues with them?
- 20. Do you know how to run reports? Can you customize reports?
- 21. What specialties have you billed or coded for?
21 Common Medical Billing and Coding Interview Questions and Answers
1. What certifications do you hold?
I am CPC, CHRS and CBCS certified.
2. Have you performed billing activities for Medicaid or Medicare? How was your experience?
I have worked with both. It was exciting working with both despite the delays and the paperwork involved. Nonetheless, the experience has taught me much.
3. How do you manage rejected or unpaid claims?
It is quite a problem when a claim gets rejected or is not paid. I make sure that no delays occur when submitting claims as I appreciate the fact that the longer a claim is unpaid, the less likely it is to be paid and can get rejected too. However, if this situation occurs, I make sure that I correct and re-submit the claim as soon as possible.
4. Have you billed or coded for any specialties?
Yes, I have. Providing coding and billing services to a mental health facility, I had to monitor the number of visits and pre-authorizations.
5. Which forms have you most often used in your current and former positions?
I have had considerable experience with CPT, HCPCS, and ICD-9 Vol 3.
6. Does your current employer use EMR or EHR?
Yes. They use both.
7. Which type of software have you used: Epic, Medisoft or other programs?
I have had extensive experience using Epic.
8. Do you have medical-billing certification? If not, are you planning to get certified or are you in the process of getting certified?
Yes, I am a Certified Billing Specialist from the AAPC
9. How do you keep current with insurance and health care coverage changes?
We are trained on a regular basis at work. Additionally, certification upgrades help and so does maintaining liaison with insurance companies and other healthcare agencies help as well.
10. How long does it take you to process one day’s worth of patient visits or claims?
It takes about two working days at the very maximum.
11. Tell me about the last claim you had denied. What happened, and how did you resolve it?
There was a time when the insurance company denied a claim for a patient’s underarm surgery saying that the procedure was cosmetic. I had the claim resubmitted with proper information. The claim was paid accordingly.
12. What’s your strategy and process for appealing a denied claim?
The first thing I do is find out just why a claim has been denied. If I feel that the denial is unfair, I consult with the doctor in question and re-file the claim providing information and proof of why it should not have been denied.
13. Tell me about your most hostile patient-collection case. What was the problem you encountered? Were you able to negotiate payment?
We had this patient whom we knew to be extremely difficult. She had a cosmetic procedure done and billed it to the agency who denied it. It was quite a horror trying to extract payment from her as she used abusive language and threatened to take us to court. We managed to negotiate payment from her by reasoning with her gently initially and then very sweetly telling her that we will take legal action. She paid three days later.
14. Do you think insurance companies sometimes play games to see if they can avoid paying claims?
I think they do. Not all of them and it is up to us to see who may be playing games following reputation and insight.
15. What’s your understanding of medical terminology?
I am comfortable with medical terminology as a whole and have extensive knowledge of terminology associated with both dermatological and ophthalmological procedures.
16. Have you billed for Medicare and Medicaid?
Yes I have
17. How do you deal with rejected or unpaid claims?
I find out why a claim has either been rejected or left unpaid. If the insurance company has made a mistake in rejecting it, I re-file it after providing further information on why it should have been paid. If the insurance company is right in denying it, I follow up with the client to solicit payment.
18. Are you comfortable working with computers? What types of software do you have experience with?
I am computer savvy. Apart from being able to work with the most common software, I am familiar with IntelleChart and ECLIPSE
19. Do you know how to submit claims to a clearinghouse? Have you ever set up a provider with a clearinghouse or resolved claim submittal issues with them?
Yes, I am familiar with claims submission procedures to clearinghouses, and I have resolved several claim submittal problems.
20. Do you know how to run reports? Can you customize reports?
Since I have worked extensively with the most common billing software, I am comfortable with both manual and automated reports generation processes.
21. What specialties have you billed or coded for?
I have worked for both ophthalmologists and dermatologists and have coded and billed for both these specialties.