17 Medical Reimbursement Specialist Interview Questions and Answers

Medical reimbursement specialists are responsible for ensuring that healthcare providers are reimbursed for the services they provide. This involves reviewing and processing invoices, maintaining accurate records, and communicating with both providers and insurance companies.

If you’re looking for a medical reimbursement specialist job, you’ll likely need to go through a job interview. Reviewing the most common medical reimbursement specialist interview questions and answers can help you prepare for what you might be asked.

Are you familiar with the medical billing process?

This question is an opportunity to show your interviewer that you have the skills and experience necessary for this role. If you are not familiar with medical billing, consider researching the process before your interview so you can answer confidently.

Example: “I am very familiar with the medical billing process because I’ve been doing it for over five years now. In my last position, I was responsible for creating invoices, submitting claims electronically and following up on unpaid claims. I also had a lot of interaction with patients who were unhappy about their bills or wanted to discuss insurance coverage.”

What are some of the most important qualities for a successful medical reimbursement specialist?

Employers ask this question to learn more about your personality and how you would fit into their team. They want someone who is organized, detail-oriented and able to work well with others. When answering this question, try to highlight qualities that you have that will help you succeed in the role.

Example: “I think one of the most important qualities for a medical reimbursement specialist is attention to detail. This job requires us to review many claims and make sure they are accurate before submitting them. I am very good at spotting errors and making sure everything is correct before sending it off. Another quality I feel is important is communication skills. In my previous roles, I always made sure to communicate any issues or questions I had with my supervisor so we could find solutions together.”

How would you rate your written communication skills?

This question can help the interviewer assess your ability to write clearly and concisely. Use examples from past experiences where you had to communicate with others in writing, such as emails or memos.

Example: “I have always been a strong writer, so I was excited when my previous employer asked me to take over their monthly newsletter. I wrote several articles each month about different topics that were relevant to our patients. This helped increase our newsletter subscribers by 50% within six months of taking on this task.”

What is your experience with working with insurance companies?

This question can help the interviewer determine your experience with working in a team environment and collaborating with other professionals. Use examples from previous work experiences to highlight your teamwork skills, communication abilities and problem-solving skills.

Example: “In my last position as a medical reimbursement specialist, I worked closely with insurance companies to ensure that all claims were submitted on time and accurately. This helped me develop strong relationships with representatives at various insurance companies, which has been helpful when I’ve needed assistance or have had questions about submitting claims.”

Provide an example of a time when you had to deny a claim. Why did you make this decision?

This question can help the interviewer understand how you make decisions and whether or not you have a strong sense of ethics. When answering this question, it can be helpful to explain your thought process in detail so that the interviewer knows you are committed to making fair decisions.

Example: “In my previous role as a medical reimbursement specialist, I had to deny a claim from a patient who was seeking treatment for a rare disease. The patient claimed they were misdiagnosed by their doctor, but after reviewing their records, I found that there wasn’t enough evidence to support their claims. While I felt bad about denying their claim, I knew that if we paid out every claim without proper review, our company would go bankrupt.”

If you could change one thing about the current healthcare system, what would it be and why?

This question is a great way to see how you view the current healthcare system and what changes you would make if you were in charge. It also shows your passion for the industry and gives insight into how you might approach change within your role as a medical reimbursement specialist. When answering this question, it can be helpful to focus on one specific aspect of the healthcare system that you feel could use improvement and explain why you think it needs changing.

Example: “If I could change one thing about the current healthcare system, I would work to reduce the amount of time patients have to wait before they receive treatment. In my experience working with insurance companies, I’ve seen many cases where patients are waiting weeks or even months to get an appointment with their primary care physician. This delay can lead to more serious health issues down the road, which can cost both the patient and the insurance company more money.”

What would you do if you noticed a pattern of fraudulent claims from a doctor or hospital?

This question can help the interviewer determine how you would handle a situation that could be challenging. Use your answer to highlight your problem-solving skills and ability to work with others.

Example: “I would first meet with the doctor or hospital administrator to discuss the issue. I would want to understand why they were submitting fraudulent claims, as this may be an unintentional mistake. If it’s clear that there is fraud occurring, I would report the incident to my supervisor so we could take action together. We would then decide whether to terminate the contract with the provider or if other actions are necessary.”

How well do you manage your time and prioritize tasks?

Time management and prioritization skills are important for medical reimbursement specialists because they often have a lot of tasks to complete in a day. Employers ask this question to make sure you can manage your time well and prioritize the most important tasks first. Use examples from your experience to show that you know how to use your time effectively.

Example: “In my previous role, I had many different responsibilities each day. However, I always made sure to start with the most urgent tasks so I could get them out of the way as soon as possible. This helped me stay focused on what was most important throughout the rest of the day. I also used my lunch break to take care of any smaller tasks that didn’t require much thought or energy.”

Do you have experience using healthcare databases and other technology tools?

This question can help the interviewer learn about your experience with technology and how you use it to complete your work. Use examples from your previous job to show that you’re familiar with using databases, software programs and other tools used in healthcare settings.

Example: “I have worked as a medical reimbursement specialist for five years now, and I’ve been working with our hospital’s database system since my first day on the job. The database is where we store all of our patient information, including their insurance details, billing codes and more. It’s also where we keep track of reimbursements and payments made by patients or their insurance companies. I’m very comfortable using this database because I use it every day at work.”

When working with doctors and other medical professionals, how do you maintain positive relationships?

This question can help interviewers understand how you interact with others and your ability to work in a team environment. When answering, it can be helpful to mention specific examples of how you have maintained positive relationships in the past.

Example: “I find that maintaining positive relationships is important when working with doctors and other medical professionals because they are often busy and may not always respond to emails or phone calls as quickly as I would like. To ensure that I maintain positive relationships, I try to remain patient and understanding while also being proactive about contacting them if I need something from them. This has helped me build strong relationships with many of my clients.”

We want to improve our claims processing time. Give me an idea of how you would improve this.

This question is a great way to see how you would apply your skills and knowledge to the company’s goals. When answering this question, it can be helpful to mention specific ways you have improved processes in the past.

Example: “I think one of the best ways to improve claims processing time is by streamlining the process. I’ve seen companies use software that allows them to upload all patient information into one database where they can view their entire medical history. This helps employees quickly find any relevant information when processing a claim. Another way to improve claims processing time is by hiring more staff members who are highly qualified and experienced.”

Describe your experience with working with claims from private insurance companies.

This question can help the interviewer understand your experience with working in a medical reimbursement department. Use examples from previous jobs to describe how you handled claims and helped clients resolve issues with their insurance companies.

Example: “In my last position, I worked primarily with private insurance companies. My primary responsibility was helping patients who had questions about their coverage or were having trouble submitting their claims. I also assisted them with understanding what documentation they needed to submit for their claims. In one instance, I spoke with a patient who wasn’t sure if her procedure would be covered by her insurance company. After speaking with her, I determined that she did have coverage for the procedure but needed to provide additional information to support her claim.”

What makes you stand out from other candidates for this position?

Employers ask this question to learn more about your qualifications and how you can contribute to their team. When answering, it’s important to highlight a skill or experience that makes you unique from other candidates. You may also want to mention something that is relevant to the job description.

Example: “I have five years of experience as a medical reimbursement specialist, which has given me valuable knowledge on how to process claims quickly and accurately. I am also familiar with many different software programs for processing claims, which would allow me to work independently if needed. In my previous role, I was responsible for training new employees on these systems, so I know I can help others succeed in their roles.”

Which medical reimbursement certification do you currently hold?

Employers may ask this question to make sure you have the certification they’re looking for. If they don’t specify which certification they want, it’s a good idea to find out what certifications they offer before your interview so that you can mention one of those if you hold it.

Example: “I currently hold the Certified Professional Medical Reimbursement Specialist credential from the American Association of Healthcare Administrative Professionals. I’ve been working toward my certification since I started in this field and am excited to finally be able to use it.”

What do you think is the most important skill for a medical reimbursement specialist to have?

This question can help the interviewer determine if you have the skills and abilities to succeed in this role. When answering, it can be helpful to identify a skill that is directly related to your experience as a medical reimbursement specialist.

Example: “I think one of the most important skills for a medical reimbursement specialist to have is attention to detail. This is because I often work with sensitive information about patients’ health care plans and treatments. It’s important that I am able to keep confidential information private while still accurately processing claims. In my last position, I was responsible for ensuring all patient information was kept secure at all times.”

How often do you complete audits of claims?

This question can help the interviewer understand your experience with audits and how you complete them. Use examples from previous work to show that you know what an audit is, how often they occur and how you handle them.

Example: “In my last position as a medical reimbursement specialist, I completed two audits per month on average. The first step was always to review all claims for accuracy. If there were any issues, I would contact the provider to make sure they had all of the necessary information to submit their claim correctly. After this, I would resubmit the claim and wait for approval.”

There is a discrepancy in a doctor’s claims. What would you do to investigate the situation?

This question is an opportunity to show your problem-solving skills and ability to work independently. When answering this question, it can be helpful to describe the steps you would take to investigate the discrepancy and how you would resolve it.

Example: “If there was a discrepancy in a doctor’s claims, I would first contact them to see if they had any information about why their claim was rejected. If not, I would then call the insurance company to find out what happened with the claim. After speaking with both parties, I would determine whether or not the insurance company made a mistake. If so, I would make sure that the doctor received payment for their services. If not, I would follow up with the insurance company until the issue was resolved.”