Health Insurance Specialist Interview Questions And Answers

Ahh, ending on a nice, easy philosophical note. Health care is changing rapidly, and employers want creative, innovative thinkers who have ideas on how to do things better. And no matter where you work in the massive health care industry, you’ll very likely have opinions of your own on this topic.

Highlight the work you’ve in your career that has helped you or your organization to stay in front of trends.

With a wider variety of providers on care teams operating at the top of their licenses, I think it will be vital to pay attention to every perspective. Collaborative and connectivity apps will help providers build a cohesive team in patient care.

Many practices need to run reports from their practice management software that show their financial status and performance, outstanding claims, patient balances, etc. The ability to create and customize these reports is a definite advantage. Many times when meeting with a provider, they will express a desire to see certain information in a certain format. Of course sometimes the reporting functions of the software can’t produce exactly what they want. Buy knowing how to extract information out of the practice management software - or database - is very important for a provider.

It is quite a problem when a claim gets rejected or is not paid. I make sure that no delays occur when submitting claims as I appreciate the fact that the longer a claim is unpaid, the less likely it is to be paid and can get rejected too. However, should this situation occur, I make sure that I correct and re-submit the claim as soon as possible.

I find out why a claim has either been rejected or left unpaid. If the insurance company has made a mistake in rejecting it, I re-file it after providing further information on why it should have been paid. If the insurance company is right in denying it, I follow up with the client in order to solicit payment.

Sometimes managing several different cases at once can be a challenge, certainly, but learning to prioritize can really help to get things under control. I always look for the work that needs to be completed the soonest. While there may be other, larger projects to worry about, I don’t like to let upcoming projects or cases slip under the rug in favor of the largest ones. I take pride in my work, and every accomplishment counts, especially in this line of work. If I miss out on a case, then it’s the client who suffers, which is not something any insurance company would want.

Such a question lets your interviewer know that you want to be effective from day one, says career coach Julie, founder of Act Three. It suggests initiative and preparation, which are critical in the employer's hiring decision. The answer should give you "more in-depth knowledge about the tasks and challenges you'll be facing in your first couple of months

This is a specific one, and the question itself will be tailored toward you and the job at stake. The gist of it is: Employers want to know your motivations.

An anecdote is the strongest way to address this question, Lin says. Sharing a personal story connects your human side with your clinical skills.

My father was terribly sick when I was a teenager, and most of my free time was spent in a caregiving role. I admit I surprised myself by how fulfilling I found it. Even though I missed a lot of social events, it instilled in me a drive to provide that level of care to others, which I’ve done throughout my career.

The most dreadful of them all. The one where they ask you to take about your own personal mistakes, mess-ups and overall failures.

This one always feels like a trap—how can they possibly give a job to someone who has failed!!—but it’s really not. The truth is you’re human and you’ve made a mistake or two on the job before. So has everyone. So has your interviewer.

No one likes talking about failure, but it can be very helpful to a prospective employer to hear you talk about how you handle it. Avoid placing blame on anyone and focus on what you learned from the experience that you choose to share. Again, like your answers to the prior questions, don’t be afraid to talk about your personal experiences.

“Never underestimate the power of the story,” Lin says. “It can convince a company that one won't quit at the first sign of a better paycheck.”

(Word to the wise: Don’t go into “full honesty” mode on this one. Definitely don’t lie, but you may want to avoid telling the interviewer about the three hazmat incidents you caused in your last job.)

I learned the hard way about how to manage night shifts about five years ago. I was so used to managing day shifts that I realized there was a whole culture of the night shift that I was unfamiliar with. On top of that, the hours were killing me. But I paid attention to my more seasoned colleagues and did some real soul-searching about how I could better handle managing the job. My first six months were tough, but after I made a few key adjustments, I great to really like that job at that time.

Just about every practice has some outstanding unpaid claims (A/R or Accounts Receivable) or patient balances. May have a significant amount of money “stranded” and waiting for claim issues to be resolved. If you have experience resolving unpaid claims and reducing A/R this is a huge plus. These type of questions are not uncommon as one of the top interview questions because so many practices struggle with unpaid claims.

Yes, I have. Providing coding and billing services to a mental health facility, I had to monitor number of visits and pre-authorizations.

Yes, I am a Certified Billing Specialist from the AAPC

Yes I have

In my old job, I was assigned alongside three other group members to the task of getting a rather large claim completed. It involved a great deal of money on the company’s part, so we really needed to be thorough about how we approached the situation. I was in charge of contacting the client themselves. Before approaching the client, I sat down and made a list of all the information I needed before returning to the office. I feel like this helped to resolve the case smoothly in the end. There was no conflict, and it seemed like everyone got the ending best suited for their position surrounding the situation.

It's a two-way street. Yes, you're there to sell yourself, but they're selling the job, too.

The answer will help you define "the organization's strengths and weaknesses with this insider's perspective," says Michael Erwin, a senior career adviser at CareerBuilder.

If this person would be your boss, and you feel at ease, you might ask: What's your management style? What challenges make you excited to come to work each day? What do you like the most about working here? These kinds of questions let somebody see that you're genuinely attracted to the job and can help you determine whether the company is a good fit for you.

You’ll face this tough one no matter the industry. And though your first instinct might be to say, “Because I’m awesome, duh?” there’s a much better way to answer this one in an interview setting.

“Most people don't know why they're better or even different from other candidates,”.

Candidates often feel like answering this question will come across as boastful, so they shy away from it or otherwise deflect.But this is your time to make your strongest case for yourself.

We recommends the “rule of three.” Provide three examples of your strengths or ways you’re unique. This makes you sound more confident and authoritative, he says.

I would be a good fit because your mission of putting the patient before anything else is exactly how I think all health care should be provided. In addition, experience in working with underserved populations gives me the advantage of being familiar with a wide variety of perspectives. Finally, my demonstrated work on committees will help strengthen your organization’s commitment to active internal leadership.

A reimbursement specialist typically uses software to conduct transactions using medical billing codes. Answer this question with details about how you find the right codes quickly, stay organized and focused, and double-check your work with industry-standard tools, such as the American Billing Association’s Medical Coding & Billing and Resource Center. Express how your goal is to reduce or prevent errors from happening entirely.

The ability to create and share documents, reports, manage and upload files, and perform back-ups are skills that are helpful for medical billing and coding jobs. You would also want to mention any word processing (Microsoft Word) or spreadsheet (Excel) programs you have experience with.

Medical billing specialists have to deal regularly with insurance companies to get an explanation why a claim was rejected and what is necessary to get it paid. Being able to understand the insurance claim process and how to deal with payers are important to getting claims paid. That’s why this is one of the top interview questions an employer would likely ask and a weakness of many providers billing efforts.

Its good practice to process claims within 72 hours (3 days) of the date of service. Providers want to know that the medical biller and coder will promptly submit claims for payment.

I am CPC, CHRS and CBCS certified.

There was a time when the insurance company denied a claim for a patient’s underarm surgery saying that the procedure was cosmetic. I had the claim resubmitted with proper information. The claim was paid accordingly.

Since I have worked extensively with most common billing software, I am comfortable with both manual and automated reports generation processes

Yes, I always try to stay up to date with the latest software programs so that I can really be an asset to my company and get my job done efficiently. I also work with PowerPoint and several other programs if they’re needed in the office.

I think they do. Not all of them and it is up to us to see who may be playing games following reputation and insight.

Knowing how to file an appeal with the insurance carrier is important in resolving denied claims. It takes patience as most all insurance companies have different processes, requirements, and timeframes for the appeal process. It’s not always straightforward for a reason.