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

If you are seeking a career in medical billing and coding, it is important to have a strong understanding of both healthcare and administrative processes. Here are the top 20 interview questions and answers to help you showcase your knowledge, experience, and cultural fit for the role.

General Questions:

• 1. What motivated you to pursue a career in medical billing and coding?
  As someone with a strong interest in both healthcare and administrative tasks, I found medical billing and coding to be the perfect blend of both. I am detail-oriented, organized, and thrive in fast-paced environments which are all essential qualities for this role.
• 2. How do you stay updated on the latest industry changes and regulations?
  I regularly attend workshops, conferences, and webinars related to medical billing and coding. I also actively participate in online forums and subscribe to industry newsletters to stay informed about current trends and updates.

Behavioral Questions:

• 3. Tell me about a time when you had a difficult interaction with a patient or colleague. How did you handle it?
  In my previous role, I encountered a situation where a patient was unhappy with their bill. I remained calm and actively listened to their concerns, empathized with their situation, and offered to talk to the billing department on their behalf. The patient left satisfied and the issue was resolved.
• 4. Can you describe a time when you had to prioritize your tasks to meet tight deadlines?
  In my previous role, we had a high volume of billing and coding to complete within a short timeframe due to an unexpected system shutdown. I quickly assessed the urgency of each task, communicated with my team to ensure we were all on the same page, and worked efficiently to meet our deadlines.

Situational Questions:

• 5. How would you handle a situation where a claim was denied due to coding errors?
  I would first review the claim and identify the specific coding errors. Then, I would discuss the issue with the healthcare provider to clarify any discrepancies. If necessary, I would also consult with the coding department to ensure accurate coding and resubmit the claim.
• 6. Imagine you received multiple insurance denials on the same day. How would you prioritize and manage them?
  I would prioritize denials based on urgency and the potential impact on revenue. For example, if a large claim was denied, I would give that priority over a smaller one. I would also ensure that I accurately document each denial and follow up with the necessary parties accordingly.

Technical Questions:

• 7. What is the difference between ICD and CPT codes?
  ICD codes, or International Classification of Diseases, are used to describe a patient's diagnosis or illness. CPT codes, or Current Procedural Terminology, are used to describe the services or procedures provided to the patient. Both sets of codes are important for accurate medical billing and coding.
• 8. Can you explain the concept of medical coding modifiers?
  A medical coding modifier is a two-digit code that is added to a CPT code to provide additional information about a service provided. It can indicate multiple procedures performed, a bilateral procedure, or the use of anesthesia, among other things.

Cultural Fit Questions:

• 9. How do you handle sensitive information and maintain patient confidentiality?
  Patient confidentiality is of the utmost importance in the medical field. I understand the importance of following HIPAA regulations and take all necessary precautions to protect patient information. I also actively communicate with my team to ensure we are all on the same page when it comes to handling confidential information.
• 10. How would you handle a situation where a colleague was not pulling their weight in a group project?
  I would start by respectfully addressing the issue with the colleague and discussing ways to improve teamwork and efficiency. If the issue persists, I would communicate with my supervisor to find a productive solution for the team.

Industry-Specific Questions:

• 11. What is a clean claim?
  A clean claim is a medical claim that is free of errors and can be processed and paid without additional information or investigation.
• 12. Can you describe the process for submitting a claim to a commercial insurance company?
  The first step is to ensure all patient information and treatment details are accurately entered into the electronic health record. Then, I would assign the appropriate ICD and CPT codes, submit the claim electronically, and follow up with the insurance company if necessary.

Work Experience & Background:

• 13. Can you provide an example of a time when you had to handle a rejected claim?
  In my previous role, we had many rejected claims due to incorrect coding. I worked closely with my team to identify patterns and implement processes to prevent future rejections. As a result, we were able to decrease rejected claims by 50% within three months.
• 14. How do you ensure compliance with regulations and coding guidelines?
  I maintain a thorough understanding of coding guidelines through regular training and certification courses. I also reference coding manuals and resources to ensure accurate coding for each procedure.

Teamwork & Communication:

• 15. How do you manage conflicts or disagreements with team members?
  I believe in open and respectful communication. If a conflict arises, I would address it directly with the team member to find a solution that works for both of us. If necessary, I would involve our supervisor to facilitate a productive conversation.
• 16. Can you provide an example of a time when you had to effectively communicate complex information to a non-technical person?
  In my previous role, I had to explain a complex medical billing process to a patient who had no medical background. I used simple, non-technical language and visual aids to help them understand the process and answer any questions they had.

Time Management & Organization:

• 17. How do you prioritize and manage your workload during busy periods?
  I prioritize tasks based on deadlines and importance, and I use a time management system to stay organized. I also communicate with my team to ensure that we are all on the same page and can support each other during busy periods.
• 18. Can you provide an example of a time when you had to handle a large volume of coding within a short timeframe?
  In my previous role, I had to code a large volume of emergency room visits in a short timeframe due to a sudden increase in patients. I worked overtime and utilized my time management skills to ensure all coding was completed accurately and on time.

Professionalism & Adaptability:

• 19. How do you handle sudden changes in industry regulations or coding guidelines?
  I am accustomed to changes in the industry and understand the importance of staying adaptable. I quickly research and familiarize myself with any new regulations or guidelines and adjust my work accordingly.
• 20. Can you describe a time when you had to adapt to a new software or system?
  In my previous role, we switched to a new electronic health record system. I enrolled in training courses and worked closely with the tech support team to become comfortable with the new system. I also actively shared my knowledge with my colleagues to ensure a smooth transition for the team.