Medical Billing/Coding Specialist Interview Questions

By Dona DeZube, Monster Finance Careers Expert

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.

You can convey these qualities when interviewing for a medical billing/coding job by preparing effective responses to these job-specific interview questions.

Practice Particulars

Your interviewer may begin the interview by asking questions tailored to his practice, says Andrea Crawford, director of career services for Kaplan College in Chula Vista, California. Questions may focus on the billing process with the insurance companies the practice’s patients most often use as well as the most common procedures the practice performs:

  • Which insurance programs have you billed? Have you billed Medicare and our state insurance program or only PPOs?
  • Which forms have you most often used in your current and former positions?
  • Which procedures have you most often billed in your current and prior positions?

Medical terminology is also important. Some employers may give a quick quiz on terminology and related codes before they hire, says Dr. Omar Sheriff, chair of the allied-health program at Kaplan College in Hammond, Indiana.

You may be asked directly about medical terminology, says Sheriff: Which medical terminology classes have you taken? Alternatively, the employer may ask about terminology related to its particular practice: Do you know what the strep test is for? Do you know what otitis media is?

Electronic Medical Records Knowledge

As the healthcare industry moves toward electronic health records over the next five years and starts recruiting for HITECH, billing will need to keep up, so be ready to discuss your experience with electronic medical records (EMRs) or electronic health records (EHRs). “If [you’ve] worked on paper and electronic claims, that’s ideal,” Crawford says.

Typical questions can include:

  • Does your current employer use EMR or EHR?
  • What work did you do with EMR?
  • What’s your computer experience been?
  • Which type of software have you used: Epic, Medisoft or other programs?
  • Which version of that program do you use?
  • Have you worked with an EMR claims clearinghouse?

Hard-Skills Questions for Medical Billing

The employer will ask about your hard skills to ensure that you can do the job accurately and file claims at a reasonable pace.
Since health insurance rules change daily, you’ll also be assessed in how you keep up with the latest edicts. “If [you’re] not keeping up, [you] may be billing incorrectly,” Crawford says.

If you make the short list of candidates, employers may even test you by having you explain what you’d do to resolve an actual denied claim (with the patient’s information excised to protect health privacy).

Questions that cover hard skills for medical-billing jobs include:

  • Do you have medical-billing certification? If not, are you planning to get certified or are you in the process of getting certified?
  • How do you keep current with insurance and healthcare coverage changes?
  • How long does it take you to process one day’s worth of patient visits or claims?

Optimally, Crawford says, employers look for billers “to be within two days of the current day to be able to keep up.”

Soft-Skills Questions for Medical Billing

Medical billers need a unique combination of soft skills, Crawford says. “They have to have a bit of fight in them and not be afraid to challenge a claim denial,” she says. “They have to be patient, flexible and able to diffuse patient emotions.” They also have to have hard conversations with patients who aren’t paying their bills.

To dig into those characteristics, employers will ask behavioral interview questions:

  • Tell me about the last claim you had denied. What happened, and how did you resolve it?
  • What’s your strategy and process for appealing a denied claim?
  • Tell me about your most hostile patient-collection case. What was the problem you encountered? Were you able to negotiate payment?
  • Do you think insurance companies sometimes play games to see if they can avoid paying claims?

By planning and practicing your answers to these questions, you’ll show hiring managers that you have the skills required to cope with the daily challenges facing medical-billing professionals and that you’ll be able to work well with patients and help maximize practice revenue.