1. Explain me what is 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.
2. Explain me how do you keep current with insurance and healthcare 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.
3. Explain me 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.
4. Explain me 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.
5. Explain me 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.
6. Tell us 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.
7. Explain 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.
8. Explain me 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.
9. Tell me how important is customer service to you?
In the end, I think customer service is what can make or break a company. Running a successful business is all about maintaining a good image with clients and customers, and you can't do that if you're treating them poorly. That's why I always remember to put my best foot forward when interacting with anyone whenever I'm given a case to evaluate, regardless of how difficult the situation or the individual in question might be. It's my priority to provide good customer service and prove myself an asset to my company while I'm there.
10. Explain me 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.
11. Explain me why Are Good Communication Skills Essential in This Field?
Interviewers want to know whether, in addition to dealing with clinical records and submitting medical claims, you can also deal with patient calls and work with other medical billing personnel to resolve disputes. This role typically requires strong verbal and written skills to effectively interact with others, so describe situations that required you to communicate effectively under pressure with co-workers and medical office personnel.
12. Tell us 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.
13. 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 most common software, I am familiar with IntelleChart and ECLIPSE
14. Tell us which type of software have you used: Epic, Medisoft or other programs?
I have had extensive experience using Epic.
15. Tell us 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.
16. Explain do You Like to Take on New Responsibilities?
The medical billing industry changes rapidly. Employers want employees who demonstrate resiliency and adaptability. Describe past experiences in utilizing patient financial information systems; adjudicating claims; processing and tracking submissions, remittances and rejections; and how you are willing to take the extra steps necessary to ensure proper cashiering, credit and collections to ensure that all patient accounts get paid in a timely fashion.
17. Tell us does your current employer use EMR or EHR?
Yes. They use both.
Yes, I am familiar with claims submission procedures to clearing houses and I have resolved several claim submittal problems.
19. Basic Health Insurance Specialist Job Interview Questions:
☛ Why do you want to work here?
☛ How do you feel about your progress to date?
☛ What are your biggest accomplishments?
☛ Tell me about yourself
☛ How well do you feel other people rate your job performance?
☛ What is your greatest strength?
☛ What is your greatest weakness?
☛ What are you looking for in your next job?
☛ What kind of salary are you worth?
☛ Any Questions?
20. Difficult Health Insurance Specialist interview questions:
☛ What type of people do you like to work with?
☛ What days and hours are you available to work? Please be as specific as possible.
☛ What qualities would you look for if hiring someone?
☛ When would you be available to start?
☛ What clubs do you belong to?
☛ Which areas of your work are most often criticized?
☛ What motivates you?
21. Behavioral Health Insurance Specialist interview questions:
☛ Can you meet deadlines? If so, give me an example.
☛ What research have you done on our firm and our industry?
☛ What new skills have you learned or developed recently?
☛ In what way did this type of work interest you and how did you get started?
☛ What is your greatest strength?
☛ Have you fired people before?
☛ What is the most difficult adjustment you have ever had to make?
22. Phone based Health Insurance Specialist interview questions:
☛ Tell me about the funniest role you have had on a job/project.
☛ How would you tackle the first 90 days at this job?
☛ Do you participate in many social activities with your co-workers?
☛ What college subjects did you like best? Why?
☛ When would you be available to start?
☛ What makes you feel proud about your job?
☛ What are two or three things you would still like to learn in this field?
23. General Health Insurance Specialist interview questions:
☛ What do (did) you not like?
☛ Wouldn't you be better off in a bigger (smaller) organization?
☛ Do you have a geographic preference?
☛ How much money do you need to make?
☛ Which is more important to you, the money or type of job?
☛ Which areas of your work are most often praised?
☛ Do you check your messages while on vacation?
24. Group based Health Insurance Specialist interview questions:
☛ What questions do you have for me?
☛ What do you find are the most difficult decisions to make?
☛ How do you define your key team members?
☛ What was your best learning experience?
☛ What are your salary increases?
☛ What personal weakness has caused you the greatest difficulty in school or at work?
☛ Does your Health Insurance Specialist work relate to any experiences or studies you had in college?
25. Panel based Health Insurance Specialist interview questions:
☛ Give me examples of projects tasks you started on your own.
☛ If you were interviewing someone for Health Insurance Specialist position, what traits would you look for?
☛ What's the most important thing you learned in school?
☛ What are the key values of a Health Insurance Specialist? How do you demonstrate these values?
☛ Have you ever had to introduce a policy change to your work group?
☛ How did you handle meeting a tight deadline?
☛ What performance standards do you have for your unit?
26. Operational and Situational Health Insurance Specialist Interview Questions:
☛ Describe your typical day at your current/previous job. How do you prioritize your work?
☛ How would you rate your proficiency with Microsoft Office programs, especially Excel?
☛ Describe your familiarity with billing and invoice software.
☛ How many invoices do you handle on a daily basis?
☛ Describe a time you had an invoice discrepancy with a client. How did you resolve it?
☛ Explain the financial transactions involved in the billing process and your experience with each (i.e. classifying, computing, posting, verifying, recording)
☛ How do you keep track of incoming payments and ensure that it is in compliance with financial procedures? How do you ensure that they're properly posted and accounted for?
☛ How do you ensure the timely collection of invoices?
☛ Describe your most hostile payment collection call. How did you handle it?
☛ Describe a time you went the extra mile to deliver excellent customer service.
☛ Describe a time you worked with a team to complete a project on a tight deadline.
☛ As a billing specialist, have you ever faced an ethical dilemma at work? How did you respond?
☛ What skills do you deem necessary for a billing specialist with our firm. Do you think you possess these skills?
☛ This job can be repetitive. What motivates you to do well?
27. Explain me 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.
28. Explain me 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.
29. Tell us what Would You Change About Existing Record Systems?
A medical reimbursement specialist facilitates the claims payment process, spanning from the time a service is rendered right up until the balance is paid. They need to know about coding, medical terminology, insurance claims and billing, appeals and denials, privacy laws and compliance regulations. Record systems in physicians' offices, billing services and health care insurance companies can be very complex. Describe a health record index or storage retrieval system you've worked with and elaborate on procedures you feel could be improved. This shows a potential employer that you take pride in your work and think about ways to make the process more effective for the business and customers alike.
30. Explain me 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.
31. Tell us 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.
32. Tell me have you ever had to negotiate in order to get your way when working in a group?
Yes. At my last position when I was working in a group which was focused around one client's auto claim, it seemed initially like no one could come to an agreement on what the accident should be covered under. One group member claimed that it rested under one policy, another employee claimed that the accident was the client's fault and should therefore be handled differently, and I had a third option which involved neither of the first two. We sat down and successfully navigated the situation until we all came to a unanimous understanding of the subject. It's my belief that we got the client the best outcome possible for their troubles.
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.
34. Explain have you performed billing activities for Medicaid or Medicare? How was your experience?
I have worked with both. It was interesting working with both despite the delays and the paperwork involved. Nonetheless, the experience has taught me much.
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.
