When you interview for a medical billing position, you may be asked several questions about your professional experience, industry knowledge, work practices and problem-solving skills.
Knowing what questions to expect can help you prepare answers ahead of time and practice before you meet the hiring manager. In this article, we explore some of the most common questions asked in a medical billing interview to help you get started.
Most common medical billing interview questions: When interviewing for medical billing roles, there will be some common ground from job to job, company to company. Here are 10 questions with example answers so you can craft your own effective responses:
In what medical billing specialties are you experienced? Medical billing specialties are based on the type of care patients receive from the provider. This question allows you to showcase how your experience meets the needs of the facility. In your answer, outline what patient procedures you've billed for and any that you would like to gain more experience in if applicable. Some specialties include billing for internal medicine, family medicine, anesthesiology, dermatology and neurology.
Example: "In my previous role, I did medical billing for an oncology practice, which I had to research and teach myself since it was my first time billing those specialized procedures. Additionally, I also have experience billing for hospitals, family and internal medicine as well as pediatrics."
What types of medical records software have you used? Medical billers typically review digital patient files, submit claims through online portals and do most of their work using industry software. When answering this question, list the software you've used in previous roles, how you used it and any training or certifications you've received. If the job description lists a specific software for the role, be sure to address your knowledge of that software, too.
"Over the past six years as a medical biller, I've worked with eClinicalWorks as well as CareCloud and Charts EHR. With eClinicalWorks, I monitored claims processing and scrubbing to ensure claims were filed with insurance companies and patients received accurate bills.
I also used it to verify patients' insurance information and eligibility. In my last role, I used CareCloud and Charts EHR for revenue cycle management, filing both paper and digital claims and sending bills to patients. With each software, I reviewed the available analytics to track how much we billed, how much had been paid by insurance at any given time and the amounts of outstanding insurance claims."
Explain a time when you had to resolve an error with a claim in the clearinghouse. A clearinghouse is an online portal where medical billers submit claims to insurance payers, and part of this process involves payers scrubbing claims and sending back any with inaccuracies. Use this question to demonstrate your knowledge of the clearinghouse and show how you address these rejections.
Example: "When there's an error with a claim, that means that the payer has found something wrong with the information we provided. My job as a biller is to review the electronic remittance advice, or ERA, that breaks down each element of the claim and the items that they're denying.
I then compare the information in our electronic health records system, or EHR, making sure the patient's name and date of birth are correct, the right amounts are attributed to copay, coinsurance and deductible amounts. I often review physician notes, diagnosis codes and procedure codes to make sure everything is correct.
Whenever I find the errors that initially caused the payer to reject the claim, I make sure to correct the information in the EHR system before resubmitting to the clearinghouse. This ensures our in-house records match the payer records." Can you explain the difference between copays, deductibles and coinsurance? These three terms represent the amount of money a payer and a patient pay for care over an insurance contract. This question assesses your knowledge of these important differences since medical billers are responsible for ensuring each amount is correctly charged on a claim. In your answer, give the definitions of each term and explain how you use this information on the job.
Example: "A copay is what the insurance requires a patient to pay when they visit. This amount may vary depending on whether the patient sees a general practitioner or a specialist. Coinsurance is any amount of a claim that an insurance payer doesn't pay. Some patients may have supplemental insurance to cover these amounts. Finally, a deductible is the amount that the patient pays out of pocket, in total, for care expenses before the insurance company pays.
Knowing the difference between these three terms help me double-check that money is charged toward the right insurance element on the explanation of benefits, or EOB, ensuring patients only pay the amount they have to pay based on their insurance plan."
How do you follow HIPAA regulations when managing patient accounts? Every patient must sign a Health Insurance Portability and Accountability Act (HIPAA) form when they see a provider. This form outlines a patient's rights to keep their medical records and insurance information private or accessible to other people as necessary. Use this question to highlight your understanding of these regulations and the importance of protecting patients' health information.
Example: "When a patient calls regarding their account, I always verify their name, date of birth and account number, if they have it. If a family member or caregiver is calling on behalf of the patient, I ask for the patient's information along with the caller's name and relationship to the patient. This allows me to check that this person is listed on the patient's HIPAA form, and I can speak with the caller about the patient's account."
If a patient calls the billing department upset about their account, how do you handle their concerns? Many medical billers are responsible for taking patient calls regarding billing and insurance, and patients can often be confused or upset when they receive a bill from their provider. This situational question tests your customer service and problem-solving skills, and you can answer this question using a hypothetical scenario or a real-life example from your experience. Use the STAR method for your answer to:
Example: "In my last role, I had a patient call about her daughter's recent visit to the doctor for strep throat. She was concerned about the amount we had billed her after filing a claim with her insurance, so I talked her through the bill over the phone. I first assured her that I could help her understand the amount she was charged. Then, I explained each procedure we billed her for—the visit and the test. I also went over her EOB to show her how much we charged for the copay when she came in, how much the insurance company was going to pay and how much the coinsurance was, which was her responsibility to pay.
The woman said that she had been confused by the different amounts and was grateful for me helping her through it. I then took her payment over the phone so that we could settle her outstanding charges as soon as possible." Explain how your previous medical experience can help you in this role. Some people become medical billers after being in direct patient care roles, and this experience can be helpful in many ways. If you have this previous experience, use this question to highlight those skills and the ways you plan to apply them in a medical biller role. Consider listing an example of a situation in which your knowledge can be an advantage.
Example: "As a former medical assistant, I'm familiar with the process of documenting diagnoses, tests and procedures, and I have a lot of experience working directly with patients.
My knowledge of note taking can help me better understand the physician notes on patient records, allowing me to more accurately create claims. Also, my bedside manner translates to customer service, so I am comfortable talking to patients who may be confused or upset about their bills."
How familiar are you with medical terminology?Patient charts and records often include doctor's notes on what kind of tests and care a patient received. Medical billers and coders often need to interpret these notes to accurately code these claims. In doing so, they must be familiar with some medical terminology, like certain conditions, procedures, tools and other jargon or abbreviations. In your answer, include an example of an instance where your knowledge of medical terms helped you on the job.
Example: "When I was going to school for medical billing, I took a course on medical terminology so I could learn how to interpret notes on patient records, speak with the medical staff about patient accounts and help patients better understand their accounts.
One time, a claim came back with an ERA that stated the diagnosis and procedure codes didn't coordinate. Since a diagnosis code has one or a few procedure codes that relate to it, I had to go back to the notes to double-check what the doctor diagnosed the patient with and what steps they took to care for them. I found that the coder may have made a clerical error while inputting the code, so I fixed the claim with the correlating code and resubmitted the claim."
Do you have any medical billing or coding certifications?There are many forms of billing and coding certifications for this field, including Certified Professional Coder (CPC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Inpatient Coder (CIC) and Current Procedural Terminology (CPT). In your answer, identify whether you have any relevant certifications. If you don't have a certification, consider expressing interest in becoming certified to show your willingness to learn.
Describe how do you prioritize different tasks throughout the dayA medical biller has many responsibilities and being able to manage your time and tasks each day can ensure your provider or healthcare group is paid on time and in full. Use this question to outline your day as a medical biller.
Example: "Each morning, I start by returning voicemails and emails from patients. Then, I check any ERAs, denials or rejections from the clearinghouse. I work with my team to research the errors and fix claims in the EHR system.
Then, I spend time going through the previous day's patients, making sure the physician's notes are signed and the claims are scrubbed. I then submit those claims through the clearinghouse. Throughout the entire day, I answer phone calls and answer questions from patients and providers about claims and accounts."
Additional medical billing questions and answersWorking in medical billing can vary greatly from place to place while having a lot of detailed specifics in each, which makes for especially broad possibilities in interview questioning. Here are some additional questions you can practice: