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Medical Biller Interview Questions

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  1. Tell me what your experiences are in working with Medicare and Medicaid representatives. See answer
  2. What is your understanding of different types of medical terminology? See answer
  3. What is your approach to dealing with rejected or unpaid medical claims? See answer
  4. Do you hold any certifications relating to medical billing or coding? See answer
  5. Have you ever needed to submit a claim to a clearinghouse? See answer
  6. How would you handle correcting an error that caused a patient or insurer to be incorrectly charged? See answer
  7. Medical billers have to work with a variety of insurance companies. Which insurance companies do you have experience working with and have you noticed any differences in the way they process claims?
  8. What would you do if the medical coder submitted codes that you didn’t recognize or did not align with the care the patient received?
  9. What is the process for closing a patient account after they completed a payment plan?
  10. Describe the confidentiality requirements that you have to uphold as a medical biller. How do you confirm a patient’s identity to ensure you are protecting their private information?
  11. Have you ever witnessed unethical debt collection processes as a medical biller? How do you prevent misconduct in your role?
  12. How do you keep a positive attitude when talking to patients about their unpaid balance or late payments on the phone?
  13. Do you know how to classify procedures based on the HCPCS code system?
  14. What is the process for getting a pre-authorization from an insurance company before clearing an upcoming treatment?
  15. Medical billers use different spreadsheet software to track the status of payments and insurance requests. Are you comfortable preserving data in spreadsheets and organizing backup files?
  16. Have you ever completed an appeal for a denied claim? What was the outcome?
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6 Medical Biller Interview Questions and Answers

Q:

Tell me what your experiences are in working with Medicare and Medicaid representatives.

A:

Most medical billing professionals will need to work closely with Medicare and Medicaid representatives on several occasions throughout the week. Since these two are government institutions, there may be different procedures and steps that your candidate will need to follow in order to process different medical claims effectively. As such, it may be especially helpful if they already have contacts within the two organizations whom they can connect to quickly if there are any questions about claims. What to look for in an answer:

  • Experience working with the two organizations
  • Understanding of how the two organizations process claims
  • Ability to connect with strangers

Example:

“I do not currently have experience working with Medicare or Medicaid, but in the past, I was a public relations specialist and connected with government representatives on a regular basis.”

Q:

What is your understanding of different types of medical terminology?

A:

Since a medical biller works with medical claims on a daily basis, they will come across complex medical terminology very often. While your medical biller may not necessarily need to have a deep medical background coming into the job, your candidate should not be daunted by complex medical terms. Someone with an interest or background in medicine is always a plus for streamlining your organization’s billing needs. What to look for in an answer:

  • Level of experience with medical terminology
  • An interest in work related to the medical field
  • Willingness and ability to learn

Example:

“I studied pre-med during my undergraduate studies before deciding not to proceed with medical school. My medical knowledge will help me excel at the medical billing job.”

Q:

What is your approach to dealing with rejected or unpaid medical claims?

A:

Your medical biller will need to work with a number of claims on a daily basis, some of which will turn out to be rejected or unpaid claims down the line. It is important for your candidate to have a strategy for dealing with these situations in a collected manner and the knowledge to resolve the situation as efficiently as possible. Your organization’s long-term financial health and trustworthiness to the community will be depending on the settlement of these types of difficult-to-settle claims. What to look for in an answer:

  • Past examples of dealing with rejection
  • A high level of understanding for dealing with unpaid or rejected claims
  • A calm and collected disposition

Example:

“First, I would find out the reason why the claim was rejected or unpaid. Then, I would get in contact with the appropriate organization or individual to work out a solution.”

Q:

Do you hold any certifications relating to medical billing or coding?

A:

While your candidate does not necessarily need to have certifications in medical billing or coding, those who already have certifications may have a leg up over other applicants. If they are hired, your organization will likely see less talent turnover and more familiarity with the job at hand. What to look for in an answer:

  • Appropriate certifications
  • Level of prior experience in billing or related field
  • Interest in a long-term career in medical billing

Example:

“I completed my CPC and CMBS certification and plan to get my CHRS certification soon as well. I find medical billing a rewarding career and continuously work to hone my skills.”

Q:

Have you ever needed to submit a claim to a clearinghouse?

A:

One of the most common avenues that your candidate will use to submit and process medical claims is through clearinghouse platforms. Their answer to this question will allow you to see both how much they understand the responsibilities of the medical billing job and their approach to working with technology. Since clearinghouse organizations now process most claims and verifications online, it is important that they are comfortable working with computers and the software necessary for processing these types of claims. What to look for in an answer:

  • Level of experience in working with a clearinghouse
  • Eagerness to work with technology to settle transactions
  • Detail-oriented approach to work

Example:

“In my previous job working with medical insurance companies, I needed to work with clearinghouse organizations and processes on a daily basis, so I am very familiar with the procedures necessary to submit claims.”

Q:

How would you handle correcting an error that caused a patient or insurer to be incorrectly charged?

A:

Medical billers work to enter data as accurately as possible, but mistakes can happen at the billing office or at the insurer. Medical billers should be able to correct billing mistakes whether they made the error or someone else caused the issue. This question allows the interviewer to learn about a candidate's understanding of the billing process, their ability to apply problem-solving skills to their job and their overall written and verbal communication skills.

A successful answer will include:

  • Steps to investigate errors
  • Consistent communication with patients
  • Knowledge of the refund process

While each company has their own processes to follow for this situation, an example of a good answer could look like this:

Example:

"Once I became aware of an incorrect charge, I would first review the patient's records to identify where the error came from, searching through the specific procedures, codes and other details in their file. After identifying the cause of the issue, I would reach out to the insurer, the doctor's office and the patient to explain the problem and provide an expected timeline for resolving the issue. I would note the issue in the patient's file and provide copies of the corrected receipts."

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