Difficult Health Insurance Specialist Interview Preparation Guide

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Having a basic understanding of medical billing terms is important not only for medical coding but also for medical billing specialists. Make sure you have a familiarity with the more basic medical terms related to billing and coding as it relates to the billing process.

We are trained on a regular basis at work. Additionally, certification upgrades help and so does maintaining liaison with insurance companies and other healthcare agencies help as well.

This is pretty self explanatory and more likely one of the top interview questions to be asked of coders. Before interviewing, its a good idea to review some of the more common codes used in their particular specialty.

I am comfortable with medical terminology as a whole and have extensive knowledge of terminology associated with both dermatological and ophthalmological procedures.

This would be one of the top interview questions for providers who have a lot of Medicare or Medicaid patients. Government payers can be difficult and challenging to bill for. CMS has more paperwork, usually takes longer to pay, and can be frustrating to deal with. Providers who have a lot of Medicare patients will want to know your knowledge and experience of Medicare and the ability to get problems resolved quickly.

The first thing I do is find out just why a claim has been denied. If I feel that the denial is unfair, I consult with the doctor in question and re-file the claim providing information and proof of why it should not have been denied.

I would expect this question to be asked more for medical coding jobs. Certification in medical billing is a definite plus, but I haven’t seen that requirement for strictly medical billing jobs. Certification does show you are committed to your profession and meet certain minimum standards. If you are not certified, a good response would be that you are working towards certification - assuming you are. But don't dwell on what credentials you don't have - emphasize the experience and skills you do have.

Medical billing and coding specialists don’t usually get involved with “hard” or intense collection efforts - this is usually left to the collection agency. But they usually are involved with “soft” type collections which may be a courtesy phone call or letter reminding the patient their insurance company has paid, they have a past due balance, and offer to make payment arrangements. For the more delinquent accounts it may be a notification that their account will be turned over to collections if arrangements are not made soon.

In the end, I think customer service is what can make or break a company. Running a successful business is all about maintaining a good image with clients and customers, and you can’t do that if you’re treating them poorly. That’s why I always remember to put my best foot forward when interacting with anyone whenever I’m given a case to evaluate, regardless of how difficult the situation or the individual in question might be. It’s my priority to provide good customer service and prove myself an asset to my company while I’m there.

Questions on HIPAA laws are increasingly becoming one of the top interview questions. Because medical billers and coders have access to sensitive patient data, it’s important to have a good understanding of HIPAA privacy requirements. You also may have responsibilities for the security of patient information and computer systems. Make sure you are up to date on HIPAA standards and can give a basic explanation of what they are and what the providers (and their staff) are responsible for.

Interviewers want to know whether, in addition to dealing with clinical records and submitting medical claims, you can also deal with patient calls and work with other medical billing personnel to resolve disputes. This role typically requires strong verbal and written skills to effectively interact with others, so describe situations that required you to communicate effectively under pressure with co-workers and medical office personnel.

I have had considerable experience with CPT, HCPCS and ICD-9 Vol 3.

I am computer savvy. Apart from being able to work with most common software, I am familiar with IntelleChart and ECLIPSE

I have had extensive experience using Epic.

The medical insurance specialist should have a good understanding of how deductibles and co-insurance are calculated, how to apply write-offs, and how to apply co-pays. Many times these are determined on the EOB by the insurance company but it’s important to understand how they are calculated. Some providers require the patient to pay their co-insurance and apply deductibles up front before claims are filed to make sure they get paid.

The medical billing industry changes rapidly. Employers want employees who demonstrate resiliency and adaptability. Describe past experiences in utilizing patient financial information systems; adjudicating claims; processing and tracking submissions, remittances and rejections; and how you are willing to take the extra steps necessary to ensure proper cashiering, credit and collections to ensure that all patient accounts get paid in a timely fashion.

Yes. They use both.

Yes, I am familiar with claims submission procedures to clearing houses and I have resolved several claim submittal problems.

☛ Why do you want to work here?
☛ How do you feel about your progress to date?
☛ What are your biggest accomplishments?
☛ Tell me about yourself
☛ How well do you feel other people rate your job performance?
☛ What is your greatest strength?
☛ What is your greatest weakness?
☛ What are you looking for in your next job?
☛ What kind of salary are you worth?
☛ Any Questions?

☛ What type of people do you like to work with?
☛ What days and hours are you available to work? Please be as specific as possible.
☛ What qualities would you look for if hiring someone?
☛ When would you be available to start?
☛ What clubs do you belong to?
☛ Which areas of your work are most often criticized?
☛ What motivates you?

☛ Can you meet deadlines? If so, give me an example.
☛ What research have you done on our firm and our industry?
☛ What new skills have you learned or developed recently?
☛ In what way did this type of work interest you and how did you get started?
☛ What is your greatest strength?
☛ Have you fired people before?
☛ What is the most difficult adjustment you have ever had to make?

☛ Tell me about the funniest role you have had on a job/project.
☛ How would you tackle the first 90 days at this job?
☛ Do you participate in many social activities with your co-workers?
☛ What college subjects did you like best? Why?
☛ When would you be available to start?
☛ What makes you feel proud about your job?
☛ What are two or three things you would still like to learn in this field?

☛ What do (did) you not like?
☛ Wouldn't you be better off in a bigger (smaller) organization?
☛ Do you have a geographic preference?
☛ How much money do you need to make?
☛ Which is more important to you, the money or type of job?
☛ Which areas of your work are most often praised?
☛ Do you check your messages while on vacation?

☛ What questions do you have for me?
☛ What do you find are the most difficult decisions to make?
☛ How do you define your key team members?
☛ What was your best learning experience?
☛ What are your salary increases?
☛ What personal weakness has caused you the greatest difficulty in school or at work?
☛ Does your Health Insurance Specialist work relate to any experiences or studies you had in college?

☛ Give me examples of projects tasks you started on your own.
☛ If you were interviewing someone for Health Insurance Specialist position, what traits would you look for?
☛ What's the most important thing you learned in school?
☛ What are the key values of a Health Insurance Specialist? How do you demonstrate these values?
☛ Have you ever had to introduce a policy change to your work group?
☛ How did you handle meeting a tight deadline?
☛ What performance standards do you have for your unit?