Medical billing and coding screening questions: credentials, code sets and specialties

Medical billing and coding screening questions should pin down, first, which side of revenue cycle the candidate actually works (professional or facility, inpatient or outpatient, coding or billing and follow-up), then whether their credential and specialty experience match the client's, and finally how accurate and productive they have been under audit. A coder with years of dermatology office visits and a CPC is not yet an inpatient DRG coder, and a strong biller is not necessarily a coder at all.

This bank is for recruiters and revenue cycle managers hiring medical coders, billers, charge entry and accounts receivable follow-up staff, often remote. The medical assistant screening questions cover front-office tasks such as insurance verification in a clinic; this page is about the coding and claims work behind them. For the remote-work side of the screen, see remote candidate screening questions.

Map the role before you screen

Ask the client which specialties, which EHR and encoder, whether the role is production coding, auditing or education, and whether there is a productivity standard and an accuracy target.

Credential questions and how to check them

As of September 2026, AAPC says CPC holders must submit 36 CEUs every two years (AAPC CEU policy). A new CPC starts as a CPC-A (apprentice) and has the A removed after proving two years of experience; AAPC counts an 80-contact-hour coding course as one year and lists other combinations (apprentice removal). AHIMA credentials such as the CCS are maintained with continuing education on a two-year cycle (AHIMA recertification).

Code set and specialty depth

You do not need to be a coder to hear depth. Ask about the specific decisions in their specialty and listen for guideline names, modifiers and documentation, not general statements about "accuracy".

1. "Which specialties have you coded daily in the last two years, and what share of your work was each?"
   • Strong answer: "Mostly orthopedics, about 70%, including surgery with global periods, and some pain management."
   • Red flags: a long list of specialties with no proportions, especially from a multi-specialty billing company where they coded a few charts of each.
2. "How do you choose an office visit E/M level under the current guidelines?"
   • Strong answer: based on medical decision making or total time on the date of the encounter, and explains how they document which one supported the level.
   • Red flags: describes counting history and exam bullet points as the main method for office visits, which reflects the rules before the 2021 changes.
3. "When would you add modifier 25, and when would you not?"
   • Strong answer: a significant, separately identifiable E/M service on the same day as a procedure, supported by documentation beyond the usual pre-procedure evaluation.
   • Red flags: "whenever there is a procedure and a visit", or uses modifiers to get past edits.
4. "The documentation does not support the diagnosis the physician listed. What do you do?"
   • Strong answer: does not code what is not documented, sends a compliant, non-leading query through the organization's process.
   • Red flags: codes to the higher-paying diagnosis, or writes a leading query that suggests the answer.
5. Inpatient: "How do you approach principal diagnosis selection when two conditions both meet the definition?"
   • Strong answer: refers to the ICD-10-CM Official Guidelines for Coding and Reporting and the circumstances of admission, and queries when unclear.
   • Red flags: picks whichever gives the higher DRG.
6. Risk adjustment: "What does a diagnosis need in the note for you to capture it?"
   • Strong answer: evidence that the condition was monitored, evaluated, assessed or treated in that encounter, signed by an acceptable provider type.
   • Red flags: codes from the problem list alone.

Billing, denials and AR follow-up

Accuracy, productivity and audits

Coding managers measure both, and experienced coders know their own numbers. Ask for them and for how they were produced, then compare with the client's standard. Do not assume one "normal" rate: charts per hour depend on specialty, chart type, EHR and whether the coder also abstracts or queries.

1. "What was your accuracy score on your last internal or external audit, and how was it calculated?"
   • Strong answer: a percentage, whether it was by claim or by code, and what the errors were.
   • Red flags: "I always pass" with no figure, or has never been audited in years of production coding.
2. "What was your productivity standard, and where did you land?"
   • Strong answer: "Standard was a set number of ED charts an hour for our facility; I averaged a little above it after three months." A specific chart type and a standard.
   • Red flags: quotes a very high rate with no chart type, or cannot say whether it was per hour or per day.
3. "Tell me about an audit finding you disagreed with. What happened?"
   • Strong answer: cited the guideline or payer policy, discussed it with the auditor, accepted the outcome either way.
   • Red flags: could not name the guideline behind their position, or never questions an audit.

Where coding experience gets overstated

Remote setup, compliance and logistics

Knockout checklist and scoring

Coding screens are full of acronyms that blur in your notes: CPC-A or CPC, COC or CIC, Resolute or athena. Interview Signal keeps a transcript on your own computer, so the credential and system names in your submittal are the ones the candidate said. For a structured write-up, use the candidate submittal template.