When interviewing for a medical biller position, expect to encounter questions focused on your knowledge of medical coding, billing software, and healthcare regulations. Prepare yourself by reviewing these frequently asked questions and crafting well-thought-out responses.
| Job Description | A Medical Biller is responsible for submitting medical claims to insurance companies and payers such as Medicare and Medicaid. They are involved in the patient registration, confirmation of patient benefits eligibility, preparation and transmission of claims, monitoring payer responses, and managing the collection of payments. They often work closely with medical coders to ensure accurate billing. |
| Skills | Attention to detail, Knowledge of medical terminology, Understanding of insurance procedures, Ability to work with billing software, Strong communication skills, Problem-solving skills, Organizational skills |
| Industry | Healthcare, Insurance |
| Experience Level | Entry to Mid-level |
| Education Requirements | High School Diploma or equivalent, although post-secondary certificates in Medical Billing or related field are often preferred |
| Work Environment | Medical Billers typically work in an office setting within a healthcare facility. They spend most of their time on computers, using medical software and communicating with insurance companies. Some may work remotely. |
| Salary Range | $30,000 to $50,000 annually |
| Career Path | Medical Billers can advance to supervisory or managerial roles with experience. They may also choose to specialize in a particular area of medical billing or transition into medical coding. |
| Popular Companies | UnitedHealth Group, Change Healthcare, Cerner Corporation |
Medical Biller Interview Questions
Can you describe a time when you had to deal with a particularly difficult billing situation? How did you handle it?
How to Answer:
When answering this question, it’s important to demonstrate your problem-solving skills and your ability to remain calm under pressure. Describe the situation in detail, explaining the steps you took to resolve it, and highlight any positive outcomes. It’s also crucial to show that you learned something from the experience.
Example:
In my previous role, I encountered a situation where a patient’s insurance company was refusing to cover a necessary procedure due to a clerical error. This was causing a lot of stress for the patient, so I took it upon myself to resolve the issue. I diligently reviewed the patient’s records and the insurance company’s policies, then identified the error. I then communicated with the insurance company, explaining the error and providing the necessary documentation to support the claim. After several discussions, the claim was approved. This situation taught me the importance of attention to detail and perseverance in my role.
How do you keep track of claim status and ensure timely follow-ups?
How to Answer:
The interviewer is looking to assess your organizational skills and your ability to stay on top of tasks in a timely manner. You should discuss the methods you use to track claims, such as using specific software or creating a spreadsheet. Also, explain how you prioritize and schedule your follow-ups.
Example:
I use a combination of a dedicated billing software and custom spreadsheets to keep track of claim status. The software allows me to input the date of submission and it automatically sets a reminder for follow-up after a certain period. In the spreadsheet, I categorize claims based on their urgency and importance, which helps me to prioritize my daily tasks. I schedule my follow-ups first thing in the morning to ensure that I don’t miss any.
How familiar are you with the use of Electronic Health Records (EHR) systems in medical billing?
How to Answer:
In your response, highlight your experience with EHR systems, specific software you have used, and how it aided in your medical billing tasks. Discuss the functions you frequently used, and how you managed to maintain accuracy and efficiency.
Example:
I have extensive experience with EHR systems, particularly with software like Epic and Medisoft. These tools were instrumental in my previous roles for billing tasks. I often used them for verifying patient insurance coverage, submitting claims, and tracking the status of claims. I am comfortable navigating these systems and use their automated features to ensure accuracy in data entry and improve efficiency in my work.
How would you handle a situation where a patient disputes a charge on their bill?
How to Answer:
The best way to answer this question is to describe your approach to resolving disputes in a professional and patient-centric manner. You should emphasize your ability to remain calm and composed, to communicate clearly and effectively, and to use your knowledge of medical billing procedures to investigate and resolve the dispute.
Example:
In situations where a patient disputes a charge, my first step is to listen to the patient’s concerns to understand their point of view. Then, I would verify the charges by cross-checking the medical codes used and the services provided. If I identify any errors, I would rectify them immediately. If the charges are correct, I would explain to the patient how the charges were determined, using clear and easy-to-understand language. I believe it’s important to maintain open and respectful communication throughout the process, and I would do my best to ensure the patient is satisfied with the outcome.
Can you explain the process you follow to ensure accuracy when coding and entering patient information for billing?
How to Answer:
When answering this question, it’s important to show your attention to detail and your commitment to accuracy. Discuss the specific steps you take when coding and entering patient information. You might mention double-checking your work, using software tools to ensure accuracy, or collaborating with other team members to verify information. It’s also beneficial to mention any specific training or experience you have in medical coding.
Example:
Accuracy is crucial in medical billing, so I always make sure to double-check my work. After entering patient information and coding services, I review all the details to catch any potential errors. I also use medical billing software that has built-in error checking to help catch any mistakes. In addition, I stay updated with the latest changes in medical coding through continuous training and professional development. This helps me to ensure that I’m always using the correct codes and entering information accurately.
What steps do you take to stay updated with the changes in medical billing codes and regulations?
How to Answer:
The candidate should explain their methods for staying current with the ever-changing landscape of medical billing. This could include attending seminars, taking online courses, subscribing to industry newsletters, or participating in professional associations. They should also demonstrate an understanding of the importance of staying up-to-date in order to maintain billing accuracy and compliance.
Example:
I stay updated on changes in medical billing codes and regulations through a multi-pronged approach. I regularly attend webinars and seminars put on by professional associations and I’m also subscribed to several industry newsletters. Additionally, I have a few reliable online sources that I check regularly for updates. I understand the importance of staying current in order to ensure accuracy and compliance in my work.
How do you ensure the confidentiality and security of patient information in your role as a medical biller?
How to Answer:
As a medical biller, ensuring the confidentiality and security of patient information is paramount. To answer this question, you should discuss the steps you take to protect patient information, such as adhering to HIPAA guidelines, using secure systems, and being vigilant about who has access to patient information. You should also mention any training or certifications you have that relate to information security.
Example:
Protecting patient’s information is a top priority for me as a medical biller. I always ensure that I’m adhering to HIPAA guidelines when handling patient information. I only use secure systems for entering and storing data, and I’m always vigilant about who has access to this information. I also regularly partake in training to stay updated on the best practices and regulations related to information security in healthcare.
What strategies do you use to manage and prioritize your workload to meet deadlines?
How to Answer:
The interviewer is interested in knowing your time management skills and how you handle multiple tasks with strict deadlines. You should highlight your ability to prioritize tasks based on urgency and importance. You can also mention any tools or techniques you use to stay organized and keep track of your responsibilities.
Example:
I typically start my day by reviewing my tasks and responsibilities. I then prioritize these tasks based on their urgency and importance. For tasks that are both urgent and important, I focus on them first. For less urgent tasks, I schedule them to be done later in the day or week. I also use a digital task management system to keep track of my tasks and deadlines. This helps me stay organized and ensures that no task is overlooked or delayed.
Can you describe your experience with handling denied claims and your process for appealing them?
How to Answer:
The candidate should highlight their knowledge of the appeals process, their ability to communicate effectively with insurance companies, and their persistence in ensuring claims are paid. They might mention their use of tracking systems to follow up on denied claims and how they approach problem-solving.
Example:
When a claim is denied, I first review the reason for denial. If I find that it was denied due to a coding error or missing information, I correct the error and resubmit the claim. If the denial seems unjustified, I write an appeal letter outlining why I believe the claim should be paid, referencing the patient’s medical records and the insurance policy terms. I then submit the appeal and track its progress. I follow up until the issue is resolved, involving the provider or office manager when necessary.
Can you explain the importance of accuracy and attention to detail in medical billing and how you maintain these in your work?
How to Answer:
The interviewer wants to assess the candidate’s understanding of the importance of accuracy in medical billing and their strategies to ensure the same. The answer should highlight the candidate’s awareness of the consequences of errors in billing, their attention to detail, and steps they take to prevent mistakes.
Example:
Accuracy and attention to detail are extremely crucial in medical billing due to the complex nature of the job. A minor mistake can lead to claim denials, loss of revenue for the healthcare provider, and inconvenience for the patients. To ensure accuracy, I always double-check all the data I input. I also make it a habit to stay updated with the latest changes in medical billing codes and regulations and regularly participate in training programs. Additionally, I use automated tools and software that lessen the chances of human error.