Health Insurance Specialist

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Yes I have

Yes, I am a Certified Billing Specialist from the AAPC

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

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.

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.

I am CPC, CHRS and CBCS certified.

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

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.