17 Reimbursement Analyst Interview Questions and Answers

Reimbursement analysts are responsible for ensuring that healthcare providers are reimbursed for the services they provide. They work with insurance companies, government agencies, and other payers to get claims paid.

If you’re looking for a job as a reimbursement analyst, you’ll need to be able to answer questions about your experience, education, and skills. You’ll also need to be able to show that you have the knowledge and ability to do the job.

To help you prepare, we’ve put together a list of sample reimbursement analyst interview questions and answers.

Are you familiar with the Healthcare Common Procedure Coding System (HCPCS)?

This question is a great way to test your knowledge of coding and reimbursement. The interviewer may ask you this question if they want to know how familiar you are with the HCPCS, which is a coding system that helps healthcare providers bill for services. Your answer should show that you understand what the HCPCS is and how it works.

Example: “Yes, I am very familiar with the HCPCS coding system. In my previous role as a reimbursement analyst, I was responsible for ensuring all claims were coded correctly using the HCPCS. This helped me ensure we billed for the correct procedures and accurately reported our revenue.”

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

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 mention a few of your own personal qualities that make you successful at work.

Example: “I think one of the most important qualities for a reimbursement analyst is attention to detail. This job requires me to review many documents and ensure I don’t miss any errors or discrepancies. Another quality I find important is communication. In my last position, I was often tasked with communicating information about reimbursements to other employees who needed it. Being able to clearly communicate information is an essential skill for this role.”

How would you rate your written communication skills?

This question can help the interviewer assess your ability to communicate with others in a professional setting. Your answer should demonstrate that you have strong written communication skills and are able to write clearly and concisely.

Example: “I would rate my written communication skills as excellent. I am very comfortable writing emails, letters and other documents that require clear and concise language. In fact, I find it easier to communicate through writing than verbally because I can be sure that everyone understands what I’m saying. This is especially helpful when working on reimbursement projects where there may be multiple stakeholders involved.”

What is your experience with working with insurance companies?

This question can help the interviewer determine your experience with reimbursement processes and how you interact with insurance companies. Use examples from previous work experiences to highlight your skills, such as communication, organization and time management.

Example: “In my last position, I worked directly with an insurance company to ensure that all claims were processed correctly. The insurance company would send me a list of claims they needed to process, and I would review each one for accuracy. If there was any missing information or if the claim didn’t meet our criteria, I would contact the employee who submitted it to get more details. Once everything was correct, I would submit the claim to the insurance company.”

Provide an example of a time when you had to negotiate with an insurance company to get a client the best possible reimbursement rate.

When answering this question, it can be helpful to mention a specific dollar amount you saved your client and how that helped them.

Example: “When I first started working as a reimbursement analyst, my company was hired by a hospital to help with their billing process. The hospital had been overcharging patients for years, which led to the state government fining them $1 million. My team worked hard to negotiate with the state government to reduce the fine to $500,000. This allowed the hospital to keep its doors open while still paying back the money they owed.”

If hired, what would be your priorities during your first few weeks on the job?

This question helps employers understand what you hope to accomplish during your first few weeks on the job. It also gives them insight into how quickly you can adapt to new work environments and expectations. Your answer should include a list of tasks that highlight your ability to prioritize, organize and manage multiple projects at once.

Example: “During my first week, I would want to get familiar with the reimbursement process for this company. I would read through all policies and procedures related to reimbursements and ask questions if anything is unclear. I would also like to meet with my supervisor to discuss their expectations for me as well as any goals they have in mind for the department.”

What would you do if you noticed a pattern of errors in a physician’s billing statements?

This question can help an interviewer determine how you would handle a challenging situation at work. Use your answer to showcase your problem-solving skills and ability to think critically about the best ways to address errors in billing statements.

Example: “If I noticed a pattern of errors in physician’s billing statements, I would first try to contact them directly to see if they were aware of any mistakes on their end. If not, I would then reach out to my supervisor or manager for advice on how to proceed with correcting the issue. In this case, I would likely need to contact the physicians again to let them know that there are still issues with their billing statements. From here, I would work with my team to ensure all billing statements are accurate before sending them to patients.”

How well do you know the Medicare laws and regulations?

The interviewer may ask this question to assess your knowledge of the Medicare laws and regulations. This is because reimbursement analysts must be familiar with these rules in order to ensure their clients are compliant with them. In your answer, try to highlight how you stay up-to-date on any changes to the Medicare laws and regulations.

Example: “I am very familiar with the Medicare laws and regulations. I have been working as a reimbursement analyst for five years now, so I’ve seen many changes to the Medicare laws and regulations. I make it a point to read through the latest updates to ensure my clients are aware of them. For example, last year there was an update to the billing codes that were no longer accepted by Medicare.”

Do you have any experience using billing software?

This question can help the interviewer determine your level of experience with reimbursement software. If you have previous experience, share what type of software you used and how it helped you complete your job duties. If you don’t have any experience using billing software, explain that you are willing to learn new software if hired for this role.

Example: “I’ve worked in a customer service position where I had to use billing software to process payments from clients. The software was easy to navigate and allowed me to enter client information, create invoices and track payments. This experience has given me an idea of what to expect when working with billing software.”

When reviewing claims, what is your process for checking for errors?

This question can help the interviewer understand how you approach your work and what steps you take to ensure accuracy. Your answer should include a step-by-step process for reviewing claims, including any specific methods or tools you use to check for errors.

Example: “I first read through each claim thoroughly to make sure I understand all of the details. Then, I compare it against the original documentation to see if there are any discrepancies. If so, I will contact the provider to clarify any questions I have about the claim. After that, I will review the claim again to make sure everything is accurate before submitting it.”

We want to increase our revenue. What ideas do you have for doing so?

This question can help the interviewer understand your ability to think creatively and develop strategies for increasing revenue. Use examples from previous experience or explain how you would approach this task if you had no prior experience.

Example: “I have a few ideas that I’ve used in my current role as a reimbursement analyst. First, I recommend creating an incentive program for employees who submit their expenses on time. This can encourage them to submit their expenses quickly so they can receive their reimbursements sooner. Another idea is to create a system where employees can track their own expenses online. This way, they can enter their expenses themselves rather than waiting for someone else to do it.”

Describe your experience with working with claims processing systems.

This question can help the interviewer determine your experience with working in a similar role. Use examples from previous work to describe how you used systems and tools to complete tasks, organized information and communicated with others.

Example: “In my last position as a reimbursement analyst, I worked with an electronic claims processing system that helped me manage all of the data for each claim. The system was easy to use and had many features that made it efficient to organize and track important information. For example, I could enter new claims into the system and assign them to specific employees or departments. Then, the system would automatically send notifications when there were updates on the status of the claim.”

What makes up a claim’s “balance due” amount?

This question is a great way to test your knowledge of reimbursement processes. It also allows you to show the interviewer that you understand how to calculate balance due amounts and can apply this knowledge in real-world situations.

Example: “Balance due amounts are calculated by taking the total amount submitted for reimbursement minus any payments already made, then subtracting any discounts or credits applied to the claim. The remaining amount is what’s owed to the patient or provider.”

Which industries do you have the most experience working in?

This question can help the interviewer understand your experience level and how it relates to their industry. Use this opportunity to explain any relevant skills you have that could be beneficial for the role, such as knowledge of specific software or compliance regulations.

Example: “I’ve worked in healthcare reimbursement for five years now, so I’m very familiar with the processes and procedures involved. In my last position, I helped implement a new system that streamlined our reimbursements and reduced processing time by 50%. This allowed us to reduce costs while still providing quality care.”

What do you think is the most challenging part of being a reimbursement analyst?

This question can help the interviewer get an idea of what you think is challenging about this role and how you would approach it. Your answer can also show your level of enthusiasm for the job, so try to focus on positive aspects of being a reimbursement analyst.

Example: “The most challenging part of being a reimbursement analyst is having to reject reimbursements because they don’t meet company policy or are not within the budget. However, I have found that by explaining why the request was denied in a kind and professional way, I am able to maintain good relationships with employees who submit requests.”

How often do you recommend updating a claims processing system?

This question can help an interviewer determine your knowledge of the industry and how you apply it to your work. Use examples from your experience to show that you know when a system needs updating and what steps you take to do so.

Example: “In my last position, I noticed that our reimbursement system was becoming outdated because we were having trouble processing claims in a timely manner. I brought this issue up at a team meeting, where we discussed possible solutions. We decided to update the system with new software that would allow us to process more claims per day. The company hired a programmer who updated the system within two weeks.”

There is a discrepancy in a claim. What is your process for investigating and resolving the issue?

This question can help the interviewer understand how you approach a problem and your ability to resolve it. Use examples from previous experience where you investigated discrepancies, found solutions and resolved issues.

Example: “I would first review all of the documentation for the claim to ensure that I have all of the information needed. Then, I would contact the provider to discuss the discrepancy in their claims. If they are unable to provide additional information, I would then contact the patient to see if there is any information they may be able to add. If the patient cannot provide more information, I would then speak with my supervisor about the issue.”