Interview questions for Medical Billing


Great medical-billing and coding professionals are chameleons — they’re able to alter themselves to adapt to daily challenges. They’re also empathetic with patients, assertive with insurance companies and analytical when they need to research claims. Are you a science graduate? Do you have an exposure in medical terminology? Do you want to become medical billing specialist? Do you want to work in the healthcare industry then start your journey from wisdom jobs online portal and gain the knowledge to become a medical billing specialist.

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Interview questions for Medical billing

1. What Certifications do you hold?

There are several Medical Coding Certifications e.g CCS, CPC, CHRS and CBCS. Just name it, if you hold any. If not you can tell that its in your future plans to become a Certified Billing Specialist from the AAPC.

2. What Is The Role Of Medical Coders And Billing People In Medical Industry?

The main duties of the individuals involved in the medical coding and billing job are
o Managing and documenting the medical related paperwork.
o Creating invoices regarding the bill for patients to insurance companies.
o Providing the necessary code for each procedure followed in billing system.
o Cross checking the patient’s bill coverage with relevant insurance company.

3. 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.

4.  Name The Codes Used To Describe The Diagnosis?

ICD -9 or International classification of diseases

5. 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, should this situation occur, I make sure that I correct and re-submit the claim as soon as possible. Further, I’ll can establishing measure to Reduce Claim Denials.

6. What Is The Core Purpose Of Superbill?

Super bill contains the procedures and diagnosis involved in the medical visit of patient, the biller thereafter uses this information while submitting the claim to relevant insurance player.

7. Which Medical Billing Coding System do you know?

I have had considerable experience with CPT 9, HCPCS and ICD-9 Vol 3. I am also studying ICD 10 Codes.

8. Do you keep updated with Insurance and Healthcare coverage changes?

Yes, I keep myself constantly updated with Medical Billing and Coding industry updates in regular basis. Additionally, certification upgrades help and so does maintaining liaison with insurance companies and other healthcare agencies help as well.

9. Abbreviate Tos?

Type of service

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. What Is The Process Involved Under Medical Billing?

o Coding (of the range – CPT, ICD -9, HCPCS)
o Entry of patient demographics
o All specialties wise – charge entry
o Payment of postings (both manual and electronic)
o Reconciliation of payments
o Re-billing and rejection/ denial analysis
o Follow up of accounts receivables
o Re-billing of systemic A/R projects
o Reporting for collection agency
o Refund options

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

Since I have worked extensively with most common billing software, I am comfortable with both manual and automated reports generation processes.

13. What Are All The Certifications Involved In The Medical Billing And Coding Field?

There are many certifications for the job seekers in the field of medical coding and billing. Some of them to be mentioned are
o Certified Medical Billing Specialist ( CMBS)
o Certified Billing and Coding Specialist ( CBCS)
o Certified Billing Specialist – Med Certification (CBS)
o Certified Healthcare Reimbursement Specialist (CHRS)

14. 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 in order to solicit payment.

15. Are You Familiar With Hipaa Privacy Rules? Security Rules?

No success story required here. Just be able to give a reasonable explanation of what security and privacy standards that the billing staff is held to. The potential employer wants to know that you are familiar enough with guidelines so as to not be a liability for them in endangering or breaching confidentiality.

16. How do you Deal 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 in order to solicit payment.

17. What is the Process for Appealing 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.

18. 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

19. 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 number of visits and pre-authorizations.

20. 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.

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