biller Interview Questions and Answers

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100 Interview Questions and Answers for a Biller

  1. What is your experience with medical billing and coding?

    • Answer: I have [Number] years of experience in medical billing and coding, specializing in [Specialization, e.g., physician billing, hospital billing, specific insurance panels]. My experience encompasses [List key responsibilities and achievements, e.g., claim submission, accounts receivable management, denial management, payer negotiations]. I am proficient in using [List relevant software and systems, e.g., Epic, Cerner, Medisoft, Availity].

  2. Explain the billing cycle from patient encounter to payment.

    • Answer: The billing cycle begins with patient registration and the creation of a medical record. Then, codes are assigned based on the services provided (CPT and ICD codes). Claims are created and submitted to the payer electronically or by mail. Following submission, claims are processed and may be rejected or require further information. The biller follows up on denials, appeals incorrect rejections, and ensures timely payment. Once payment is received, the account is closed.

  3. What are CPT and ICD codes, and how are they used in billing?

    • Answer: CPT (Current Procedural Terminology) codes are used to describe medical procedures and services performed. ICD (International Classification of Diseases) codes are used to describe diagnoses. Both are essential for accurate claim creation. The CPT code identifies the service, while the ICD code explains the medical necessity of that service. Accurate coding ensures proper reimbursement.

  4. How do you handle claim denials?

    • Answer: I systematically investigate each denial. I first identify the reason for denial using the payer's explanation of benefits (EOB). This might include missing information, coding errors, or authorization issues. Then I take corrective action, such as resubmitting the claim with the necessary corrections or appealing the denial if it is deemed incorrect. I maintain detailed records of all denial appeals and resolutions.

  5. What is your experience with different insurance payers?

    • Answer: I have experience billing for [List payers, e.g., Medicare, Medicaid, Blue Cross Blue Shield, Aetna, United Healthcare]. I understand the specific requirements and regulations of each payer, including their claim submission processes, coding guidelines, and reimbursement rates.

  6. How do you prioritize your tasks and manage your workload?

    • Answer: I prioritize tasks based on urgency and importance, focusing on timely claim submission and resolving denials promptly. I use [mention tools or methods, e.g., task management software, prioritization matrices] to organize my workload and ensure deadlines are met. I am adept at multitasking and managing multiple accounts simultaneously.

  7. Describe your experience with electronic health records (EHR) systems.

    • Answer: I have extensive experience with [List EHR systems, e.g., Epic, Cerner, Allscripts]. I am proficient in navigating the system to extract necessary patient information for billing purposes, including demographics, diagnosis codes, and procedure codes. I am comfortable with integrating data from the EHR into billing software.

  8. How do you stay updated with changes in medical billing and coding regulations?

    • Answer: I stay current by regularly reviewing industry publications, attending webinars and conferences, and participating in continuing education courses offered by organizations like the AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management Association). I also actively monitor changes to payer guidelines.

  9. How do you handle difficult patients or situations?

    • Answer: I approach difficult situations with patience and empathy. I actively listen to the patient's concerns and try to understand their perspective. I clearly explain billing procedures and answer their questions thoroughly. If necessary, I escalate the issue to a supervisor for further assistance.

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