Top Interview Questions for Medical Billing and Coding Jobs

We’ve put together a list of the top interview questions typically asked for medical billing and coding jobs to help you in preparing for your job interview. Also included is the reason they are asking these questions and what the interviewer is likely looking for. These are questions we’ve either been asked or have asked ourselves when interviewing for medical billing jobs.

What’s your understanding of medical terminology?

Having a basic understanding of medical billing terms is important not only for medical coding but also for medical billing specialists. Make sure you have a familiarity with the more basic medical terms related to billing and coding as it relates to the billing process.

What type of certifications do you have?

I would expect this question to be asked more for medical coding jobs. Certification in medical billing is a definite plus, but I haven’t seen that requirement for strictly medical billing jobs. Certification does show you are committed to your profession and meet certain minimum standards. If you are not certified, a good response would be that you are working towards certification – assuming you are. But don’t dwell on what credentials you don’t have – emphasize the experience and skills you do have.

Have you billed for Medicare and Medicaid?

This would be one of the top interview questions for providers who have a lot of Medicare or Medicaid patients. Government payers can be difficult and challenging to bill for. CMS has more paperwork, usually takes longer to pay, and can be frustrating to deal with. Providers who have a lot of Medicare patients will want to know your knowledge and experience of Medicare and the ability to get problems resolved quickly.

How do you deal with rejected or unpaid claims?

The longer claims go unpaid, the less likely it is they will be paid. Getting denied or rejected claims corrected and re-submitted can be a lot of revenue to a provider. A prospective biller or coders effectiveness and experience here is very important to a practice’s accounts receivables and likely one of the top interview questions.

Are you familiar with Electronic Medical Records (EMR) systems? Which ones have you used. How did you use it?

The use of medical records software – also referred to to as EMR or EHR software – is increasingly important to providers. They may want the biller and/or coder to enter and maintain information in the EMR system. Employers value someone who is proficient in electronic medical records software and know how to use it. It can also be a valuable asset to the biller and coder in their job when verifying patient information and treatments for a claim. Many billing and practice management software programs are increasingly integrated or interface with the EMR system.

Are you comfortable working with computers? What types of software do you have experience with.

The ability to create and share documents, reports, manage and upload files, and perform back-ups are skills that are helpful for medical billing and coding jobs. You would also want to mention any word processing (Microsoft Word) or spreadsheet (Excel) programs you have experience with.

What practice management or medical claims software do you have experience with?

Once you’ve learned on practice management or medical billing software program, it’s pretty easy to learn another. Most well written software is fairly intuitive to use. If you’ve only used on software, you might effectively make this point and emphasize your computer skills.

Do you know how to submit claims to a clearinghouse? Have you ever set up a provider with a clearinghouse or resolved claim submittal problems with them?

Sometimes there are format or compatibility problems when sending claims to a clearinghouse – especially when setting them up. There’s also a lot of paperwork and forms to fill out when you sign up a provider or practice. Most clearinghouses also provide valuable reporting features to help scrub and catch claim errors so they can be corrected before being sent to the insurance company. Being able to use these features and tools and understand them is valuable experience.

Do you know how to run reports? Can you customize reports?

Many practices need to run reports from their practice management software that show their financial status and performance, outstanding claims, patient balances, etc. The ability to create and customize these reports is a definite advantage. Many times when meeting with a provider, they will express a desire to see certain information in a certain format. Of course sometimes the reporting functions of the software can’t produce exactly what they want. Buy knowing how to extract information out of the practice management software – or database – is very important for a provider.

What specialties have you billed or coded for?

Certain specialties have unique coding and billing requirements. For example some mental health specialties have limitations on the number of visits and require pre-authorizations. These have to be monitored so there are no surprises for either the patient or the provider. If you don’t have experience in this particular providers specialty, emphasize your experience in billing for other unique specialties and your ability to adapt and understand the unique billing requirements for specialties.

What procedure codes are you most familiar with?

This is pretty self explanatory and more likely one of the top interview questions to be asked of coders. Before interviewing, its a good idea to review some of the more common codes used in their particular specialty.

Can you explain the difference between co-pays, deductibles, and co-insurance?

The medical insurance specialist should have a good understanding of how deductibles and co-insurance are calculated, how to apply write-offs, and how to apply co-pays. Many times these are determined on the EOB by the insurance company but it’s important to understand how they are calculated. Some providers require the patient to pay their co-insurance and apply deductibles up front before claims are filed to make sure they get paid.

Are you familiar with HIPAA privacy and security rules?

Questions on HIPAA laws are increasingly becoming one of the top interview questions. Because medical billers and coders have access to sensitive patient data, it’s important to have a good understanding of HIPAA privacy requirements. You also may have responsibilities for the security of patient information and computer systems. Make sure you are up to date on HIPAA standards and can give a basic explanation of what they are and what the providers (and their staff) are responsible for.

Have you dealt much with insurance companies to resolve issues with unpaid or rejected (denied) claims?

Medical billing specialists have to deal regularly with insurance companies to get an explanation why a claim was rejected and what is necessary to get it paid. Being able to understand the insurance claim process and how to deal with payers are important to getting claims paid. That’s why this is one of the top interview questions an employer would likely ask and a weakness of many providers billing efforts.

Have you worked on insurance or patient accounts receivables?

Just about every practice has some outstanding unpaid claims (A/R or Accounts Receivable) or patient balances. May have a significant amount of money “stranded” and waiting for claim issues to be resolved. If you have experience resolving unpaid claims and reducing A/R this is a huge plus. These type of questions are not uncommon as one of the top interview questions because so many practices struggle with unpaid claims.

Have you ever appealed a denied claim? What’s your process in resolving a denied claim?

Knowing how to file an appeal with the insurance carrier is important in resolving denied claims. It takes patience as most all insurance companies have different processes, requirements, and timeframes for the appeal process. It’s not always straightforward for a reason.

What’s your experience in patient collections?

Medical billing and coding specialists don’t usually get involved with “hard” or intense collection efforts – this is usually left to the collection agency. But they usually are involved with “soft” type collections which may be a courtesy phone call or letter reminding the patient their insurance company has paid, they have a past due balance, and offer to make payment arrangements. For the more delinquent accounts it may be a notification that their account will be turned over to collections if arrangements are not made soon.

How do you deal with difficult or angry patients?

If you are a medical billing specialist, you will eventually deal with an angry patient. A lot of times they don’t understand their insurance coverage and they take their frustrations out on you – the bearer of the bad news. So when they receive a statement, that’s usually when they call the billing department and want to know why they owe something – or why it’s so much. That’s when it’s important for the biller to patiently explain their insurance coverage and if they desire more info to call their insurance company. Questions about dealing with patients are typically one of the top interview questions for billers.

How long does it take you to process a day’s charges?

Its good practice to process claims within 72 hours (3 days) of the date of service. Providers want to know that the medical biller and coder will promptly submit claims for payment.

If You Just Can’t Answer Top Interview Questions – Turn a Negative Into a Positive
There will inevitably be interview questions you just can’t answer – or a situation you don’t have experience in. In those cases don’t answer in a negative way – such as “I can’t….” or “I don’t know…”. Answer the question in a way as to emphasize your strengths or knowledge or your ability to learn and adapt quickly. Potential employers prefer candidates who will not require a lot of hand holding or be a burden on the existing staff. They want someone who can get up to speed quickly and take initiative.

So for example if you don’t have any experience with Electronic Medical Records systems and they asked you about it, don’t panic. You can answer in a way that explains you do have good computer skills and experience on a variety of practice management systems – you can get up to speed on a new software within a day. You might also state that most of these programs are intuitive and your computer skills will apply to EMR software also.

Most Important Question
Probably the most important question asked in an interview isn’t even a question – “Tell me about yourself” is probably one of the top interview questions for any occupation. It’s an open-ended opportunity for you to sell yourself.

It’s not really for you to tell all your hobbies, interests, and personal stuff, but where you can summarize your experience, training, accomplishments, etc. and how they relate to the job. Don’t get too long winded responding, but just have a 5 minute or less statement that you can express why your are the best candidate for the job.

Success Stories
In addition to preparing to answer these top interview questions, have some “success stories” or example you can give that demonstrate your ability to take action and solve problems. You can bring these up during the interview. Potential employers will be very impressed. Giving examples of what you can do can really impress the interviewer make you stand out from the other candidates.

Situation – a short overview of where and when.

Problem – state the problem or challenge.

Action Taken – describe the action(s) you took to solve the problem.

Results – give quantitative results of your actions – like “reduced accounts payable by 75%.” or “reduced unpaid claims by 50%.”

These kinds of short success examples or stories can really impress a potential employer and demonstrate how you can help them – even if you are weak in certain areas mentioned in the top interview questions above. Ideally having two or three of these examples you can go to when you need to. There’s no reason you can’t also put these examples on your resume.

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