Interview Questions to Ask a Potential Medical Billing and Coding Specialist

Although the growing field of medical billing and coding is creating many potential candidates it does not mean that they are all well trained and articulate enough to get the job done. Because of the flood of schools covering this training, many are not fully qualified to teach the entire spectrum needed by future employers. These schools can be a reputable two or even four year college program to a three to six month online course simply setup to cover the basics at a reduced tuition. To the student, some of these fast track programs look attractive but by the time they set down their resume it is apparent that they are not a viable candidate. Therefore, asking the appropriate questions will determine whether they can stand up to or surpass their resume credentials.

Please review the training you completed?

A potential medical billing and coding specialist should have no problem giving you the required list of their training experience. Although it may be on their resume it is good practice to see if they can list them to determine if they are good at recollection as well as able to construct an articulate sentence. This will include the school they attended and the course of study they completed. The basic foundation courses stated should be: medical billing I and II, coding I and II, physician and hospital based chart auditing, anatomical medical terminology, medical billing software and physician and hospital case study.

Did you sit for the national medical billing and coding certification exams?

Certification is essential for a specialist that will be advantageous to your company. Again this may be on their resume however it will continue the rapport you may be looking for as well as give you an idea of their attitude towards the entire process.

Can I see your certification and training degree?

Believe it or not some potential employees will simply hand you a resume in the hope of being hired. You must ask for copies of their degree and certification. If they do not have this at their interview then you may want to re-think their candidacy. Certification should include one or more of the following:

CHRS - Certified Healthcare Reimbursement Specialist / National Electronic Biller Alliance
CMS - Certified Billing Specialist / Med-Certification
CMBS - Certified Medical Billing Specialist / Medical Association of Billers
CBCS - Certified Billing and Coding Specialist / Med-Certification

What kind of computer will you be working on?

The last thing you want is to hire someone who does not have the required setup. If their operating system is old and slow you will most likely suffer when it comes to needed speed and accuracy. Make sure they not only have an updated system but are able to handle any additional software you may provide.

Tell me about where you have been working prior to this interview?

Obviously, the more experience a candidate has the more beneficial they will be to you. Find out where they worked and be sure to obtain contact info of these employers for a reference call. Ask them how they felt about their prior job and what, if any, would they like to experience differently when they come to work for you.

Experience Questioning

The following questions will help you assess the true knowledge of your applicant. These are simple enough for anyone with at least two years experience to answer. If they do not have two years experience then you will have to determine whether you are okay with on the job training.

If an office visit and a procedure is billed on the same day, by the same provider, but are very different from one another, what modifier would you use? Answer: 25

What is the purpose of a superbill? Answer: A superbill contains the procedures and diagnosis for a patient's medical visit. The biller uses this information to submit a claim to the proper insurance payer.

What does RA stand for? Answer: Remittance Advice

Name the code descriptions for diagnosis? Answer: ICD-9 a/k/a International Classification of Disease

What form are professional claims submitted on? Answer: HCF-1500 or CMS-1500

How open and capable are you of learning our system?

The answer you receive to this question will immediately let you know if this person is a team player or not.

Can you tell me what your responsibility is regarding HIPAA (Health Insurance Portability and Accountability Act) compliance?

This is essential for the safety of patient health information.

Hopefully these questions will help you hire the best medical billing and coding specialist you can find. Overall, you want someone who is qualified, competent and possesses an excellent work ethic.

Ph.D. Ceete Sheekels is a Certified Professional Coder (CPC) and a Certified Evaluation & Management Coder (CEMC) through the American Academy of Professional Coders (AAPC). To find out more about her visit http://aboutmedicalbillingandcoding.org.

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