Top 20 Interview Questions & Answers for Billing and Coding Specialist Roles – 2025

Preparing for a billing and coding specialist job interview? This guide provides a list of essential questions and answers that will help you showcase your knowledge of medical billing and coding procedures, your attention to detail, and your ability to handle sensitive information. Whether you’re applying for a role in a hospital, clinic, or private practice, these questions cover all key areas of the job.

General Questions

• 1. What sparked your interest in becoming a billing and coding specialist?
  A: I have always had a passion for the healthcare industry and I wanted to find a way to contribute to it without having direct patient interaction. Billing and coding allows me to use my organizational skills and attention to detail to support the careers of healthcare professionals.
• 2. Can you explain the difference between CPT and ICD codes?
  A: CPT codes, or Current Procedural Terminology, are used to describe medical services provided to a patient, while ICD codes, or International Classification of Diseases, are used to identify medical diagnoses.
• 3. How do you ensure accuracy and attention to detail in your work?
  A: I have developed a system of double or even triple-checking my work to ensure accuracy. I also take the time to thoroughly review charts and medical documents to avoid any data entry errors.
• 4. How do you handle pressure and prioritize tasks in a fast-paced environment?
  A: I have learned to manage my time effectively by creating a schedule and setting deadlines for myself. I also prioritize urgent tasks while still meeting all necessary deadlines.
• 5. What experience do you have with electronic health records (EHR) systems?
  A: I have experience working with multiple EHR systems, including EPIC, Cerner, and Allscripts. I am comfortable navigating these systems and I understand their importance in the healthcare industry.

Technical Skills & Experience

• 6. How do you ensure compliance with HIPAA regulations in your work?
  A: I make sure to stay up-to-date on all HIPAA regulations and I regularly attend training courses to maintain my knowledge. I also have a strict confidentiality policy and am careful with handling sensitive patient information.
• 7. What coding certifications do you currently hold?
  A: I currently hold a Certified Professional Coder (CPC) certification from the American Academy of Professional Coders (AAPC) and a Certified Coding Specialist (CCS) certification from the American Health Information Management Association (AHIMA).
• 8. Can you explain the difference between inpatient and outpatient coding?
  A: Inpatient coding is used for patients who require an overnight stay in a healthcare facility, while outpatient coding is used for patients who do not require an overnight stay.
• 9. How do you handle denials and rejections from insurance companies?
  A: When a claim is denied or rejected, I thoroughly review the codes and documentation to determine the mistake. If there was an error on my end, I correct it and resubmit the claim. If the mistake was on the insurance company's end, I follow up and appeal the decision.
• 10. Can you explain the difference between a clean claim and a dirty claim?
  A: A clean claim is one that is accurately coded and is free of any errors or missing information. A dirty claim is one that has errors or missing information, which can cause delays or denials from insurance companies.

Behavioral Questions

• 11. Can you give an example of a time when you had to resolve a discrepancy in coding?
  A: During my previous job, I encountered a situation where the physician's documentation did not match the codes I assigned. I discussed the discrepancy with the physician and was able to resolve it by thoroughly reviewing the documentation and making necessary adjustments to the codes.
• 12. Tell me about a time when you had to meet a tight deadline. How did you handle it?
  A: In my previous role, I had a large volume of claims to process in a short amount of time due to an unexpected staff shortage. I prioritized my tasks and worked efficiently to meet the deadline without sacrificing accuracy.
• 13. How do you handle difficult or unhappy patients who may contact you about their bills?
  A: I remain professional and empathetic while actively listening to their concerns. I then work with them to find a solution, whether it be helping them understand their bill or navigating through the insurance process.
• 14. Can you tell me about a time when you had to adapt to a new coding software or system?
  A: In my previous role, our company implemented a new coding software. I took the initiative to attend training sessions and seek assistance from more experienced team members to quickly become proficient in the new system.
• 15. Describe a situation where you had to work with a difficult coworker or supervisor.
  A: I had a coworker who was consistently not meeting their deadlines, which affected my ability to complete my own tasks on time. I approached them and had an open and honest conversation about the impact of their behavior. Together, we were able to come up with a solution that worked for both of us.

Situational Questions

• 16. How would you handle a situation where you discovered an incorrect code was used by a coworker and it resulted in a denied claim?
  A: I would first talk to my coworker about the error and ask them to explain their reasoning for the code they used. I would then review the documentation and codes together to determine the mistake. If necessary, I would discuss the situation with a supervisor to come up with a solution.
• 17. Imagine you are working on a complex bill that requires multiple levels of coding. How would you ensure accuracy and compliance?
  A: I would thoroughly review the documentation and codes multiple times to ensure all necessary codes are included, and I would also consult resources such as coding books or online databases to confirm accuracy. I would also make sure to follow all relevant coding guidelines and regulations.
• 18. How do you handle competing priorities and deadlines?
  A: I prioritize tasks based on urgency, but also take into consideration any necessary deadlines. I communicate with my team and supervisor to make sure we are all on the same page and can work together to meet our goals.
• 19. How would you handle a situation where a patient is being billed incorrectly and they refuse to pay?
  A: I would first apologize for the inconvenience and empathize with the patient's frustration. I would then review the billing information and try to determine the mistake. If necessary, I would gather more information and work with the patient to find a solution that satisfies both parties.
• 20. What steps do you take to ensure confidentiality and security of patient information?
  A: I make sure to follow all HIPAA regulations and company policies regarding the secure handling of patient information. I also take precautions such as locking my computer screen when away from my desk and properly disposing of any paper documents containing sensitive information.