charge auditor Interview Questions and Answers

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100 Charge Auditor Interview Questions and Answers

  1. What is a charge auditor?

    • Answer: A charge auditor reviews medical bills and claims to ensure accuracy, compliance with regulations, and proper coding before payment. They identify and correct errors, preventing unnecessary healthcare costs.

  2. Describe your experience with medical billing and coding.

    • Answer: (This answer will vary depending on the candidate's experience. It should include specifics about their knowledge of CPT, HCPCS, ICD codes, and experience with various billing systems. For example: "I have five years of experience reviewing medical charts and assigning appropriate CPT and ICD codes. I'm proficient in using [mention specific billing software] and have a strong understanding of medical terminology.")

  3. Explain your understanding of CPT, HCPCS, and ICD codes.

    • Answer: CPT codes describe medical procedures and services. HCPCS codes are used for healthcare products, supplies, and services not covered by CPT. ICD codes classify diseases and injuries.

  4. How do you identify fraudulent or abusive billing practices?

    • Answer: By comparing billed charges to the medical record, looking for inconsistencies, upcoding, unbundling, duplicate billing, and services not medically necessary. I also look for patterns and outliers in billing data.

  5. What software or systems are you familiar with for charge auditing?

    • Answer: (This answer will vary. Mention specific software like Epic, Cerner, Meditech, or other billing and coding software. Include any experience with electronic health records (EHR) systems.)

  6. How do you handle discrepancies between the medical record and the bill?

    • Answer: I document the discrepancies, attempt to reconcile them through additional review of the record or by querying the provider, and escalate unresolved issues to a supervisor.

  7. What is your experience with regulatory compliance, such as HIPAA?

    • Answer: (Describe experience with HIPAA compliance, including patient privacy and data security protocols. Mention any training received.)

  8. How do you prioritize your workload when dealing with a high volume of claims?

    • Answer: I prioritize based on urgency, complexity, and potential financial impact. I may use a ticketing system or other organizational tools to manage my workflow effectively.

  9. Describe your attention to detail and accuracy.

    • Answer: (Provide specific examples of how you maintain accuracy in your work. This could involve double-checking work, using checklists, or implementing quality control measures.)

  10. How familiar are you with different types of healthcare facilities (hospitals, clinics, etc.)?

    • Answer: (Describe your experience with different healthcare settings and how their billing practices may vary.)

  11. How do you stay updated on changes in medical coding and billing regulations?

    • Answer: I regularly attend industry conferences and webinars, subscribe to relevant publications, and participate in continuing education programs to stay abreast of changes in coding and billing regulations.

  12. How do you handle disagreements with providers regarding billing practices?

    • Answer: I approach these situations professionally and diplomatically, explaining my findings clearly and supporting them with evidence. I aim for a collaborative solution.

  13. What are some common billing errors you've encountered?

    • Answer: (List common errors, such as incorrect coding, missing modifiers, upcoding, unbundling, and duplicate charges.)

  14. How do you manage your time effectively to meet deadlines?

    • Answer: I utilize time management techniques such as prioritizing tasks, breaking down large projects into smaller manageable steps, and setting realistic deadlines.

  15. What is your experience with data analysis and reporting?

    • Answer: (Describe experience with data analysis and reporting, including any experience with data visualization tools. Mention any experience generating reports to identify trends and areas for improvement.)

  16. Explain your understanding of medical necessity.

    • Answer: Medical necessity refers to whether a service or procedure is appropriate and necessary for a patient's diagnosis or treatment. It's determined based on established medical guidelines and standards of care.

  17. How do you handle stressful situations or tight deadlines?

    • Answer: (Describe strategies used to manage stress and meet deadlines, such as prioritizing tasks, delegating when possible, and taking breaks.)

  18. Describe a time you identified a significant billing error. What was the outcome?

    • Answer: (Provide a specific example. Describe the error, how you identified it, and the steps you took to correct it. Quantify the impact of your correction if possible.)

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