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Interview Questions for a Medical Billing Specialist

Interview Questions for a Medical Billing Specialist

By: Dona Dezube

Great medical billing and coding professionals are chameleons — they are 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 uncover all those qualities in job applicants — if you know how to interview.

Start with interview questions tailored to your practice, suggests Andrea Crawford, director of career services for Kaplan College, Chula Vista, California.

Start by asking about the billing process with the insurance companies that your patients most often use, including the most common procedures done by your organization:

  • 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 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, Hammond, Indiana.

You can ask directly about medical terminology: Which medical terminology classes have you taken, says Sheriff, or tackle the issue by asking about terminology related to your 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 it’s important to ask job candidates about their experience with electronic medical records (EMR) or electronic health records (EHR).

“If they’ve worked on paper and electronic claims, that’s ideal,” Crawford says.

  • 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
Knowing how to interview medical billing job candidates about hard skills ensures that the person you hire can do the job accurately and file claims at a reasonable pace. 

Since healthcare insurance rules change daily, you’ll also need to assess how the job seeker keeps up with the latest edicts.

Some organizations test candidates who make the short list by having them explain what they’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 in the process of getting certified?

“If they’re not keeping up, they may be billing incorrectly,” Crawford says.

  • How do you keep up-to-date 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, “You’d want people 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, ask behavioral questions:

  • Tell me about the last claim you had denied. What happened, and how did you resolve it?
  • What are your strategy and process for appealing claim denials?
  • 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?

Knowing how to interview can help to uncover the skills required for a medical billing professional to cope with daily challenges. Recruiting a new hire properly will enable you to maximize your practice revenue and work well with patients.