Health Insurance Specialist

☛ 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?

☛ 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?

☛ 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?

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?

Yes. They use both.

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.

I have had extensive experience using Epic.

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

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.

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.

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.

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.

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.

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.

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.

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.

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