Health Insurance Specialist Interview Preparation Guide
Download PDF

Health Insurance Specialist based Frequently Asked Questions in various Health Insurance Specialist job interviews by interviewer. These professional questions are here to ensures that you offer a perfect answers posed to you. So get preparation for your new job hunting

62 Health Insurance Specialist Questions and Answers:

1 :: Tell me what do you see as the future of health care?

Ahh, ending on a nice, easy philosophical note. Health care is changing rapidly, and employers want creative, innovative thinkers who have ideas on how to do things better. And no matter where you work in the massive health care industry, you’ll very likely have opinions of your own on this topic.

Highlight the work you’ve in your career that has helped you or your organization to stay in front of trends.

With a wider variety of providers on care teams operating at the top of their licenses, I think it will be vital to pay attention to every perspective. Collaborative and connectivity apps will help providers build a cohesive team in patient care.

2 :: Tell us do you know how to run reports? Can you customize reports?

Many practices need to run reports from their practice management software that show their financial status and performance, outstanding claims, patient balances, etc. The ability to create and customize these reports is a definite advantage. Many times when meeting with a provider, they will express a desire to see certain information in a certain format. Of course sometimes the reporting functions of the software can’t produce exactly what they want. Buy knowing how to extract information out of the practice management software - or database - is very important for a provider.

3 :: How do you manage rejected or unpaid claims?

It is quite a problem when a claim gets rejected or is not paid. I make sure that no delays occur when submitting claims as I appreciate the fact that the longer a claim is unpaid, the less likely it is to be paid and can get rejected too. However, should this situation occur, I make sure that I correct and re-submit the claim as soon as possible.

4 :: Explain how do you deal with rejected or unpaid claims?

I find out why a claim has either been rejected or left unpaid. If the insurance company has made a mistake in rejecting it, I re-file it after providing further information on why it should have been paid. If the insurance company is right in denying it, I follow up with the client in order to solicit payment.

5 :: Tell me when you are working on multiple cases at once as a claims specialist, how do you decide which one takes priority over the others?

Sometimes managing several different cases at once can be a challenge, certainly, but learning to prioritize can really help to get things under control. I always look for the work that needs to be completed the soonest. While there may be other, larger projects to worry about, I don’t like to let upcoming projects or cases slip under the rug in favor of the largest ones. I take pride in my work, and every accomplishment counts, especially in this line of work. If I miss out on a case, then it’s the client who suffers, which is not something any insurance company would want.

6 :: Tell me how would I exceed your expectations on a short-term basis, say, in the first 30 to 60 days on the job?

Such a question lets your interviewer know that you want to be effective from day one, says career coach Julie, founder of Act Three. It suggests initiative and preparation, which are critical in the employer's hiring decision. The answer should give you "more in-depth knowledge about the tasks and challenges you'll be facing in your first couple of months

7 :: Explain me why did you choose [your sector within health care] as a profession?

This is a specific one, and the question itself will be tailored toward you and the job at stake. The gist of it is: Employers want to know your motivations.

An anecdote is the strongest way to address this question, Lin says. Sharing a personal story connects your human side with your clinical skills.

My father was terribly sick when I was a teenager, and most of my free time was spent in a caregiving role. I admit I surprised myself by how fulfilling I found it. Even though I missed a lot of social events, it instilled in me a drive to provide that level of care to others, which I’ve done throughout my career.

8 :: Explain me what’s your biggest career mistake or failure?

The most dreadful of them all. The one where they ask you to take about your own personal mistakes, mess-ups and overall failures.

This one always feels like a trap—how can they possibly give a job to someone who has failed!!—but it’s really not. The truth is you’re human and you’ve made a mistake or two on the job before. So has everyone. So has your interviewer.

No one likes talking about failure, but it can be very helpful to a prospective employer to hear you talk about how you handle it. Avoid placing blame on anyone and focus on what you learned from the experience that you choose to share. Again, like your answers to the prior questions, don’t be afraid to talk about your personal experiences.

“Never underestimate the power of the story,” Lin says. “It can convince a company that one won't quit at the first sign of a better paycheck.”

(Word to the wise: Don’t go into “full honesty” mode on this one. Definitely don’t lie, but you may want to avoid telling the interviewer about the three hazmat incidents you caused in your last job.)

I learned the hard way about how to manage night shifts about five years ago. I was so used to managing day shifts that I realized there was a whole culture of the night shift that I was unfamiliar with. On top of that, the hours were killing me. But I paid attention to my more seasoned colleagues and did some real soul-searching about how I could better handle managing the job. My first six months were tough, but after I made a few key adjustments, I great to really like that job at that time.

9 :: Explain me have you worked on insurance or patient accounts receivables?

Just about every practice has some outstanding unpaid claims (A/R or Accounts Receivable) or patient balances. May have a significant amount of money “stranded” and waiting for claim issues to be resolved. If you have experience resolving unpaid claims and reducing A/R this is a huge plus. These type of questions are not uncommon as one of the top interview questions because so many practices struggle with unpaid claims.

10 :: Tell me have you billed or coded for any specialties?

Yes, I have. Providing coding and billing services to a mental health facility, I had to monitor number of visits and pre-authorizations.