Medical billing and coding interview questions and answers
Medical billing and coding interviews test accuracy and follow-through: how you work a denied claim, how you keep coding accurate, how you query a provider when documentation is unclear, and how you hit productivity targets without cutting corners. Answer with a real claim or chart situation, the steps you took and what you changed afterwards.
What the revenue cycle manager is listening for
Billing and coding work is mostly invisible until something goes wrong: a claim is denied, an audit finds errors, cash slows down. So interviewers listen for three habits: you check before you submit, you dig into why a claim failed rather than just resubmitting, and you ask the provider instead of guessing.
Many interviews are by video and some include a short coding test. Be ready to name the code sets you've used, such as ICD-10-CM for diagnoses and CPT for procedures in outpatient settings, and the specialties you know best.
Denied claims
Show a method, not "I fix it and resend it." Say the steps in order.
- Read the denial reason on the remittance, not just the amount.
- Sort it: a front-end error (demographics, eligibility, authorization), a coding error, or a medical necessity or documentation issue.
- Fix the cause, correct the claim or gather documentation, and appeal if the denial is wrong.
- Track it until it's paid or closed, within the payer's filing limits.
- Look for the pattern. One denial is a claim problem; ten of the same is a process problem.
Example answer (made-up details):
"At a cardiology clinic I noticed we were getting the same denial from one payer for echocardiograms, about a dozen in a month. Each one was for missing prior authorization. Instead of appealing them one by one, I pulled the list and found that a new referral coordinator didn't know this payer required authorization for that test. I met with her and the office manager, and we added the payer to the authorization checklist. Those denials stopped the next month, and we appealed the open ones with the authorizations we could get retroactively."
Coding accuracy
Interviewers want to hear about your checks. Useful things to mention:
| Habit | What you could say |
|---|---|
| Code from the documentation | "If it isn't documented, I don't code it." |
| Check edits before submitting | "I run claims through the scrubber and read every edit, not just clear it." |
| Specificity | "I code to the highest specificity the note supports." |
| Audits | "I ask for feedback from audits and keep a list of my own repeat errors." |
| Updates | "I review the annual code updates for my specialty before they take effect." |
If you know your audit accuracy, say it. If not, say how you've been audited.
Provider queries
This tests whether you can talk to a busy physician respectfully and without leading them. A query asks for clarification; it doesn't suggest the answer that pays more.
Example answer:
"The documentation for an inpatient mentioned low sodium in the labs and IV fluids, but no diagnosis. I sent a query asking the physician to clarify whether there was a related diagnosis, with the lab values and treatment listed, and options including 'clinically undetermined.' I didn't suggest a specific diagnosis. She added hyponatremia to the note, and I coded from the updated documentation."
The ethics question
"A provider asks you to code a higher level than the notes support." Answer plainly:
"I'd explain what the documentation currently supports and what would need to be documented for the higher level. If the provider still insisted, I'd raise it with my supervisor or compliance. I won't code beyond the record."
This is one of the most important answers in the interview. Say it calmly and without hesitation.
Productivity
Many employers set charts per hour or claims per day. Show you can hit targets while protecting accuracy: batching similar charts, using templates for common queries, and flagging complex charts so they don't hide in your numbers. If you met a specific target, say so.
Mistakes to avoid
| Mistake | Why it hurts | Instead |
|---|---|---|
| "I just resubmit denials" | Shows no root-cause thinking | Read the reason, fix the cause, look for patterns |
| Leading queries | A compliance risk | Neutral questions with clinical facts and options |
| Hesitating on the upcoding question | Sounds like you might do it | A clear no, and who you'd escalate to |
| Claiming 100% accuracy | Not believable | Your audit results and how you improve |
Explaining a process out loud is harder than doing it, so practice your denial story spoken. Speaking Coach's AI interviewer follows up on what you say ("How did you know it was the authorization?"), and you can retry the moment after the feedback.
Questions people ask
Do I need certification for a billing and coding job?
Many employers ask for a coding credential; requirements vary. Name any certification you hold or are working toward, and the specialties you've practiced on.
How do I answer if I'm newly certified with no job experience?
Talk about your coding practicum or practice charts, your accuracy on them, and how you check your own work. Mention any front desk or billing office experience too.
Will there be a coding test?
Often, yes, especially for coding roles. Ask what format it takes and which code books or software you can use.
How do I talk about remote work?
Describe your routine, how you stay reachable for queries and how you protect patient information at home. See why do you want to work remotely.