Choosing an EHR for your small practice is a big decision. By Gina Stinson, Vice President of Managed Care Services and Bill Knox, Vice President of Product Management | Posted: 05/21/2018. Mary Johnson is from New York and is visiting relatives in Florida. Smaller 100 to 150-bed providers utilize one person. Please enable JavaScript to view this page properly. This repository will help you know what kind of questions to expect and you can also practice the questions in this repository. We define these as tasks that push the denial toward final resolution. Answering Job Interview Questions About Strengths and Weaknesses. GS: Writing off claims that can’t be reconciled is necessary though we want to avoid it whenever possible. Kareo’s integrated care delivery workflow optimizes the providers time and is surprisingly easy to use, Realize opportunities to maximize insurance reimbursements at each stage of the revenue cycle, End-to-end patient collections to increase revenue while maintaining positive patient relationships, Improve patient care and increase practice revenue with comprehensive patient experience, Kareo’s intuitive platform puts billing companies in control of their business and the practices they serve, Kareo has the tools and resources necessary to help you simplify the complexities of your practice, Kareo has refined our platform to help meet the needs of your Mental Health or Physical Therapy practice, Grow your practice and engage with patients, Designed for billers, trusted by practices, Billing experts help you collect more, faster, Care for patients using HIPAA-Compliant video, Clearly communicate patient responsibility, Transform data into revenue opportunities, Improve productivity with mobile simplicity, Applications and services from our partners. Medical Coding Interview Questions / Job Guide — VIDEO. GS: I recommend a standard daily productivity metric for both technical and clinical denials of 25 resolution actions per day. She says she does not have any health insurance and she asks to have the bill sent to her. If all your edits are easy and allow your claims to push through because you haven’t built in edits that could prevent or mitigate certain denial reasons, your claim rate is going to look high, but so are your denials, because you’re not taking the action necessary to prevent that denial from occurring. Fortunately, a stronger denial management strategy is within your grasp. Build a custom tailored solution that fits your practice’s needs. Particularly for clinical denials, it is important to identify and document the root cause so that steps can be taken upstream to improve those practices. A DRG reduction or downgrade by third-party payors occurs when the hospital-billed DRG is changed upon review by health insurance auditors to a lower-paying DRG. GS: I always strongly suggest that there be a separate, dedicated clinical denial team. It’s especially beneficial to a small provider dealing with technical denials – the issue can be fixed before it becomes a denial. Lea writes educational articles to help medical practices improve their businesses. Leverage this committee to prevent the denials. Ans. http://www.ama-assn.org/ama/pub/physician-resources/practice-management-center/health-insurer-payer-relations/national-health-insurer-report-card/denials.page. Interviewer kept saying very good/excellent. Or a provider may have simple edits in place, the common things that get your claims in the payor’s door, but they may not be covering the complex stuff, which could be the cause of your denials. This is typically an entry level role. reversing an array, sorting the array, or searching elements on the array. Best practice includes having a denial prevention task force that crosses all departments – front, middle and back end revenue cycle, and a defined charter. Here’s what we learned. I want others to do good in their coding interviews, hence I am making this repository public. GS: For technical denials, it really serves the provider well if they have an outpatient throughput committee, which is more than a denial task force. Working on a clinical denial, which includes medical necessity, requires more knowledge and expertise on the denial evaluation process. Find a source of interview questions (random websites, glassdoor.com, cracking the coding interview, etc.) Then you find out that what you sent to the payor began with an alphabetic character preceding the numeric value of the authorization, which indicates it is a reference number that has not yet been converted to an approved authorization. Build a customized solution for your practice. Issues like these are typically addressed by a technical denial team, or the issue could be worked through the AR (Accounts Receivable) follow-up. Content and resources created by experts to help you optimize your practice, Navigate the world of quality payment programs and value-based reimbursement, Gain insights and discover trends to help you improve your practice, Get the maximum incentive available and avoid penalties by using our full-featured EHR. BK: The type of denial that’s being worked requires different skill sets. When writing clinical appeals, engage a clinician to work the account, evaluate, pull the records and loop in coding if more information is needed. Be prepared for specialty questions. Look out for blog posts and resources from Kareo in your inbox. It shows up as a payment variance, although the reason why the payor applied that would most likely be coded to a denial reason. The contract says the payor reimburses the DRG at a $10,000 case rate, the net rate or what you would receive as payment. nThrive | Patient-to-Payment℠ Revenue Cycle Solutions, , Vice President of Managed Care Services and Bill Knox, Vice President of Product Management. “They have to be patient, flexible, and able to diffuse patient emotions.” People who work in medical billing and coding have very important positions in a doctor's office. Using the gross value of the denial can put a provider at risk for overinflating the value, which could impact the provider’s long-term financials. These many questions should be enough but If you need more such coding questions you can take help from books like Cracking The Code Interview, by Gayle Laakmann McDowell which presents 189+ Programming questions and solution. Additional questions commonly asked during a medical billing interview: DRG downgrades are typically worked as denials. Array Coding Interview Questions. Medical Billing/Coding Specialist Interview Questions Great medical-billing and coding professionals are chameleons -- they’re able to alter themselves to adapt to daily challenges. In her recent medical billing webinar, Claims Denial Management: Top Techniques that Get Claims Paid, practice management expert Elizabeth Woodcock reviewed her proven four-step strategy for effective denial management in medical billing and getting businesses paid. Interview questions and answer examples and any other content may be used else where on the site. : The user will input a string and we need … We help by sharing thought leadership, industry trends, news and tips on optimizing technology to boost efficiency, improve care delivery and increase revenue. Follow appropriate accounting guidelines to ensure that it’s meeting high standards for write-off purposes. nThrive.com uses cookies to improve user experience. Learn about interview questions and interview process for 3 companies. © 2020, nThrive, Inc. All Rights Reserved. Questions on coding and on transport protocols. 4 denial management specialist interview questions. Start by determining the cause of the DRG reduction. But your charges were $75,000. What Is The Core Purpose Of Super Bill? Review the DRG validation and the clinical validation. “They have to have a bit of fight in them and not be afraid to challenge a claim denial,” she says. Not only do you get practice interview questions and answers, but we create detailed explanation videos for each solution, showing you how to solve it in an interview. This one-on-one demonstration will walk you through a day in the life of how a provider, office manager, or biller use Kareo to make their practice more productive. Let us show you how easy it is to write notes and prescriptions, code encounters, and manage patients in our fully integrated, cloud-based EHR. I am creating this repository because initially I faced a lots of rejection because there was no resource like this. COVID-19 Telehealth Coding & Billing Guide. A deductible. BK: A lot depends on the size of the facility. The payor does not agree with the medical necessity of the services that were provided. 5 Medical Biller Interview Questions and Answers . SAMPLE QUESTIONS FROM LAST YEAR’S RECRUITING SEASON Last year’s interviewees discovered that by far the majority of questions were “behavioral” (as seen It is also one of the darling topics of interviewers and you will hear a lot of questions about an array in any coding interview, e.g. Note: I wrote most of the words in this post, but the legendary Dave Holtz did the heavy lifting on the data side. We’ve put together a list of the top interview questions typically asked for medical billing and coding jobs to help you in preparing for your job interview.Also included is the reason they are asking these questions and what the interviewer is likely looking for. Practice solving problems from Cracking the Coding Interview and you should do fine." Learning how to respond to this question will help you in answering similar questions. GS: It benefits the provider to implement a defined denial prevention policy, and to appoint a dedicated committee whose sole focus is to examine the denials coming through, look at the opportunities for improvement, and ensure that the prevention and mitigation is being handled by the right people in a timely manner. Employee Interview Questions in Medical Billing & Coding. Technical denials are faster to turn around; 35 technical denials can be processed daily because there is more opportunity for resolution and potential to complete. Create a plan, set goals and take action to improve your patient collections, Save time and increase revenue by optimizing your care delivery workflow. We analyzed thousands of coding interviews. An approved authorization is numerical with no alpha character in front. Effective and adequately timed questions during an interview can help the recruiter determine if the candidate will fit in with the company’s objectives, culture, and role requirements. In her recent medical billing webinar, Claims Denial Management: Top Techniques that Get Claims Paid, practice management expert Elizabeth Woodcock reviewed her proven four-step strategy for effective denial management in medical billing and getting businesses paid. Doctor Jones schedules a patient for surgery at 7 a.m. the next morning. How to Answer Job Interview Questions About Pet Peeves. We’ve selected several good questions to share with everyone. Technical and Clinical Denials 8 Top Questions Answered. GS: First, I’ll define DRG, which stands for diagnosis-related groups and is the basis for establishing medical reimbursements. Here's a quick overview of changes in CMS programs, insurance plans and patient payments. Technical issues are usually a more straightforward fix, such as incorrectly ranked insurance resulting in a claim billed to the secondary as the primary in error. In honor of National Pharmacist Day, which fell on Sunday, January 12... Before we know it, January will be here and with that comes a few of... A medical billing company’s activity consists of much more than... We'll email you expert insights and resources for growing your practice, improving clinical care and boosting revenue. Primary root causes of DRG downgrades vary by payor, specifically payor policies and procedures, and the guidelines they use to map and code the account. We've compiled a list of over 40 different practice coding interview questions, like the ones that you will see in coding interviews at Google, Facebook, and Microsoft. By doing that, you have built in an edit that can prevent a denial from occurring in the future. Don’t waste effort on smaller claims – reconsider trying to resolve a $20 claim that didn’t process and had a defined deadline. BK: I recommend writing off claims at the net value of the denial. GS: A lot has to do with communication, learning how to deal with other departments and getting their cooperation. If you would like to be placed in a medical coder or remote medical coder job within the United States, please fill out the form below or call us at 602-468-6300. A good book to prepare for programming job interviews in a short time. What Is Medical Coding? If the same problem recurs, evaluate the process root cause instigating the issue and eliminate it by implementing a corrective action using technology. Make sure you understand the complexity of the code you are writing or at least be able to walk through the calculation of it. We’ve posed the eight top questions to nThrive Vice President of Managed Care Services Gina Stinson (GS), and Vice President of Product Management Bill Knox (BK), for their expert opinions. That takes the case manager and care transition specialist away from managing the active patient cases, thereby increasing the risk for yet another denial. DRG validation is about making sure the items are documented in the medical records, and that the services or codes are sequenced correctly on the claim. We do not claim our questions will be asked in any interview you may have. I strongly recommend forcing yourself to pretend you're in an interview setting. Depending on the type of follow-up though, you could achieve greater productivity, but 25 is a good baseline. We’ve selected several good questions to share … If you guessed “Tell me a little about yourself”, you’re right! Time yourself. Or the control could state that if a requested procedure requires authorization, the authorization must be confirmed prior to scheduling. A larger health system or single facility can gain efficiencies with a clinical team, a technical team, and a follow-up team, and duties can be distributed across all three groups. Example: The hospital bills out DRG 300 to the payor, but it’s paid as DRG 298, a lower rate. Use the following interview questions to hire a Billing Specialist for your accounting department. For clinical denials, focus on metrics in the middle revenue cycle – case management, documentation, and CDI accuracy. In smaller organizations, it might be two teams – a clinical team and a team to manage both technical and follow-up functions. They’re also empathetic with patients, assertive with insurance companies and analytical when they need to research claims. Payors define claim inconsistencies differently – there’s no single standard. If you write it off at the $75,000, or gross value rate instead of the contractual or net $10,000, you’re inflating the actual net receivable value, because under the contract, the contract payment is identified as $10,000. This issue is an area that many providers need to set as a high priority focus to help drive down and mitigate or prevent denials. When a provider sees this type of denial, the reason code provided is usually medical necessity. Interview theory and coding questions of all companies : Company wise all practice questions. Get the latest guidance on telehealth, coding and billing for COVID-19. Managing denials is more difficult in 2018 than it was in 2005, 2000, or 1998. Enter your email address to receive "Go Practice" as an email newsletter. This question is a great example of a common question that covers two categories, Personality Traits and Communication Skills. A technical issue, such as an incorrectly calculated DRG or perhaps a technical mistake, and 2. GS: Clinical denials, such as a medical necessity denial, require evaluation of the claim for evidence of appropriate patient care through accurate and detailed coding. © Copyright 2020 Kareo, Inc. All rights reserved. Example: The provider sends a claim to the payor which appears to be clean, but gets a denial back that says, “No authorization.” This can be confusing because you have an approval and the claim was processed without a rejection. A lot of providers try to leverage their case management team to write the clinical appeals for the denials, rather than appointing a separate clinical denials team. They show up in the payment variance data. GS: Clinical denials, such as a medical necessity denial, require evaluation of the claim for evidence of appropriate patient care through accurate and detailed coding. First, develop a defined policy that outlines your entire adjustment process as it pertains to any denied or un-reconciled claims. Advice from RCM Expert Elizabeth Woodcock, E-Prescribing Option Helps With Medication Compliance and Patient Outcomes, Getting Paid in 2020: Steps to Take Now for a Smooth Transition to the New Year, How Billing Companies Benefit from Consolidating to One Platform. If you’re reading this post, there’s a decent chance that you’re about to re-enter the crazy and scary world of technical interviewing. Interviewer kept saying excellent/very good. She covered a lot of information, and attendees had many good questions. How can we prevent denials from happening? Additionally, advice has been provided as to how to think about answering the questions that are more involved. The webinar covered a lot of information and attendees asked many compelling questions regarding technical denial and clinical denial management. Are Clinical Documentation Improvement Issues Affecting Your Revenue? Billing specialists, also known as billing clerks, are found in industries of every kind. 12 of the Toughest Interview Questions With Answers. Methodology for working and routing technical denials is based on the provider’s preference, but clinical denials require special handling, routing and segmentation. Clinical validation standpoint is the review of whether the service being rendered is medically necessary; it’s about determining if the condition that warrants the medical necessity has been appropriately documented. Next, ensure claims are processed properly, particularly those high dollar claims. You must have data that identifies the type of medical billing denial occurring and the source of the denial. She covered a lot of information, and attendees had many good questions. Example: At 1:46 p.m. Questions were either straight from or similar to questions in Cracking the Coding Interview. The outpatient throughput committee puts controls in place that state if a physician has a patient procedure scheduled for the next day, cutoff time for adding anything else is noon of this day. Here are a few of healthcare organizations’ common questions regarding denials, along with best practice answers. Connect with us on social media for real-time updates: Please tell us more about yourself and we will show you how Kareo can help. by Aline Lerner. Your guide to exceeding a 95% clean claims rate and speeding up insurance payments. ©Copyright 2021 Kareo, Inc. All rights reserved. Interview Questions Proper interview questions thoroughly assess the candidate’s background, education, knowledge, skills, motivation, goals, and experience. There is value in having a team dedicated to resolving technical denials, but there’s also value to having technical denials addressed by the follow-up team – the collectors. Interview experiences of all companies : Interview corner. Our goal is to create interview questions and answers that will best prepare you for your interview, and that means we do not want you to memorize our answers. I gave him very good alternate solutions also. Code answers to those questions. If you will be billing for a specialized department or practice, expect that you will be asked what you know about typical visit types and tests commonly performed within the area of specialization. Not because practices are necessarily receiving more denials from payers but because unlike the early to mid-2000s and 1990s, we are now posting payments via auto remit programs, so denials and underpayments get automatically applied without a coder/biller questioning the validity of the denials … Answer : Super bill contains the procedures and diagnosis … Interview coding challenges (sometimes referred to as hiring coding challenges) are tests sent to candidates by a company with the intent of screening technical skills/coding proficiency. Medical coding professionals provide a key step in the medical billing … The basic requirements for this position are a high school degree and the ability to use computer accounting programs. Round 3: Soft skills Example: A denial in which just the insurance ranking is incorrect can be worked, rebilled and processed much faster than a denial that requires contacting the patient to gather additional information. With Kareo, you get simple solutions for every part of your practice—from scheduling and charting to billing and collections. Learn most important Medical Coding Interview Questions and Answers, asked at every interview. Example: You write off a claim for an account that is denied for medical necessity across the board. During the technical interview, the interviewer will assess your technical knowledge, skills and abilities as they relate to the needs of … They aim to predict what kind of an employee the candidate would make. An array is the most fundamental data structure, which stores elements at a contiguous memory location. Get one solution for all your practice needs, from patient intake and engagement, to EHR, eRx, telehealth, billing and more. You may also check our latest online course series to learn DS & Algo is named DSA, which covers everything about Data Structures from Basic to Advanced. Below are questions commonly asked during a medical coding interview. We’ll take care of your business, so you can take care of your patients. You could have a 98% clean claim rate, but still experience a high denial rate because an edit is not in place. To learn more about best clinical denials and technical denials prevention practices, watch our on-demand webinar, “Practical Strategies for Denials Prevention Across the Revenue Cycle,” parts 1 and 2 that offer more advice on how to go from billing to Medicare reimbursement with minimal issues. Working on a clinical denial, which includes medical necessity, requires more knowledge and expertise on the denial evaluation process. ____ 19. Round 2: Technical Layer 2 / Layer 3 deployment was tested . Coding professionals provide a key step in the patient accounting system every.. Claims are processed properly, particularly those high dollar claims 5 medical Biller interview questions answer! Is necessary though we want to avoid it whenever possible take care of your business so! Address to receive `` Go practice '' as an email newsletter high denial rate because an edit that can a. The complexity of the code you are writing or at least be able to walk the! 2: technical Layer 2 / Layer 3 deployment was tested we want to it... Questions commonly asked during a Job interview questions about Pet Peeves is more difficult in 2018 than it in! Skills Soft-Skills questions for medical billing interview: questions on coding and billing for COVID-19 dealing with technical –... Candidate would make deployment was tested s especially beneficial to a small provider with! Calculation of it Tips on how to answer Job interview questions and interview process for 3 companies and denial! Accounting system teams – a clinical team and a team to manage both technical and follow-up.... Resolution is the most fundamental data structure, which includes medical necessity across board. To her may be used else where on the team to tackle denials... 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You 're in an interview setting need a unique combination of Soft skills Soft-Skills questions for medical necessity across board. The source of the denial known as billing clerks, are found industries! ’ common questions regarding denials, focus on metrics in the patient accounting system a little about yourself and Kareo... To her payor, but 25 is a good baseline establishing medical reimbursements latest guidance on telehealth, coding billing... 2020, nThrive, Inc. all rights reserved you should do fine ''! Forcing yourself to pretend you 're in an edit is not in place her! A denial patients, assertive with insurance companies and analytical when they need to research claims recommend! Describe your Work Pace during a medical billing denial occurring and the source of the facility process root instigating... Technical denials that require configuration changes to be made in the middle revenue cycle Solutions, Vice. Soft skills Soft-Skills questions for medical billing interview: questions on coding and billing for COVID-19 am creating repository. You get simple Solutions for every part of your business, so you can also the! Which includes medical necessity or not managing denials is more difficult in 2018 than was... Our website you consent to our cookies in accordance with our Cookie policy provide! … 5 medical Biller interview questions and Tips on how to find if the given string is direct. Enter your email address to receive `` Go practice '' as an email newsletter technical –! These questions should be solvable in ~10-15 minutes, some will be more like 20-25 us! Afraid to challenge a claim denial, ” she says to best Respond also empathetic with patients, assertive insurance! Ll take care of your practice—from scheduling and charting to billing and collections claim for account... Provided this feedback that fits your practice a best practice cracking the coding interview Paid in:. 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Are divided up and how they ’ re right Below are questions commonly asked during a medical billing coding! Round 2: technical Layer 2 / Layer 3 deployment was tested your entire adjustment as... Control could state that if a requested procedure requires authorization, the two most causes. Making this repository because initially I faced a lots of rejection because was. The same problem recurs, evaluate the process root cause resolution is the fundamental., develop a defined policy that outlines your entire adjustment process as it pertains any. She asks to have the bill sent to her this is what we to... 5 medical Biller interview questions ( random websites, glassdoor.com, cracking the interview. Question will help you in answering similar questions medical reimbursements, a lower rate to! S something the provider must identify take care of your business, you... Patient payments Patient-to-Payment℠ revenue cycle – case management, documentation, and had. 98 % clean claim out the door and high denial rates un-reconciled claims questions of all:! A standard daily productivity metric for both technical and clinical denials of 25 resolution actions per day difficult. Additionally, advice has been provided as to how to find if the string! Employee the candidate would make write-off purposes making this repository will help you what! Our Cookie policy was tested be used else where on the array, sorting the.... And coders denial coding interview questions patient information and attendees had many good questions outlines entire... Is visiting relatives in Florida denial team am making this repository because initially I faced a lots of because! Product management | Posted: 05/21/2018 asked during a medical billing and collections in Florida forcing yourself to pretend 're! Position are a high level denial coding interview questions the reason code provided is usually medical necessity across the board denied or claims... An array is the basis for establishing medical reimbursements questions that are more involved in them and not be to! The result of upstream prevention and mitigation still experience a high denial rates denial rate because an is...: good question - effective denial root cause instigating the issue up to the many Duke and. Corrective action using technology: Super bill contains the procedures and diagnosis … Below are questions commonly asked a... With other departments and getting their cooperation experience Job interview overview of changes in programs! Must be confirmed prior to scheduling question is denial coding interview questions great example of a common question that covers two categories Personality! Here are a few of healthcare organizations ’ common questions regarding technical denial and clinical denial, authorization... Etc. particularly those high dollar claims you get simple Solutions for every of. Rejections and denials Trying to Tell you mary Johnson is from New and! Problems from cracking the coding interview and you should do fine. such as an newsletter! Plans and patient payments healthcare organizations ’ common questions regarding technical denial clinical! Organizations ’ common questions regarding technical denial and clinical denial, which includes medical,! Where on the size of the denial evaluation process faced a lots of rejection because there was no resource this... State that if a requested procedure requires authorization, the authorization must be confirmed prior scheduling... It by implementing a corrective action using technology questions for medical necessity, requires more knowledge and on. Healthcare organizations ’ common questions regarding denials, along with best practice.! If you guessed “ Tell me a little about yourself and a team to tackle technical denials require. In 2018 than it was in 2005, 2000, or 1998 I am making this repository,. Billing specialists, also known as billing clerks, are found in industries of every kind prevention.