Fresh Health Insurance Specialist Interview Questions & Answers:

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.