Medical Claims Examiner Interview Questions and Answers

Updated on: April 1, 2019

Before appearing for a medical claims examiner interview, make sure that you are prepared.

Your preparation will include answering questions regarding your ability to process claims in a timely manner, as well as examining them to ensure viability.

Prior to the interview, test yourself in various areas. For instance, ask yourself questions that you feel will be asked at the interview.

Since you will primarily be tested on your knowledge of insurance companies, particularly in a claims capacity, this is the area that you need to brush up on.

To see what questions you may be asked at the interview, have a look at the following set:

See also: Medical Claims Examiner Cover Letter

Medical Claims Examiner Interview Questions and Answers

What was the main reason you decided to work as a medical claims examiner?

I have always been interested in claims work, ever since I did an internship in an insurance company 6 years ago. One thing led to another, and I found myself working as a medical claims examiner.

What duties have you performed while working as a medical claims examiner?

While working as a medical claims examiner I have performed many tasks, such as investigating claims, verifying patients’ accounts, and handling payouts. In addition, I have been managing verifications of claims, as well as associated documents.

Moreover, my duties included reviewing pricing methodologies, ensuring compliance, and processing claims.

What is the one skill that you depend on while working as a claims examiner?

I do not depend on just one skill. In fact, working as a medical claims examiner means that you have to possess an amalgamation of skills. Where mine is concerned, I am well-versed in creating plans for claims verification, as well as handling associated documentation.

Furthermore, I am talented in determining fraudulent claims. Also, my expertise lies in processing claims in a quick and efficient manner.

Can you recount a time when you were faced with a problem but came out shining?

Yes. There was an incident when a claim that looked obviously okay was, in fact, an incorrect one. Even though all my colleagues were convinced otherwise, I decided to investigate it further. And it was indeed a fake one, which would have cost the organization a huge amount in payout for no reason.

What is the most difficult part of working as a medical claims examiner?
I find the work challenging but not difficult, which is why I cannot think of anything that may be considered a problem.

What are your 5-year plans?

Professionally speaking, I want to climb the ladder to the position of a claims specialist soon.

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