Medical Billing Test

Summary of Medical Billing test

This test checks whether a candidate can run the billing side of a medical practice. It covers diagnosis and procedure coding, besides submitting claims and handling appeals. It asks whether they keep electronic health record documentation compliant and also looks at how they reconcile explanation of benefits statements and manage the revenue cycle.

This screening test will help you hire billing and coding professionals who can submit accurate claims and keep patient records compliant.

Covered skills

• Medical coding
• Insurance and claim management
• Billing and reimbursement
• Communication and documentation

Use the Medical Billing test to hire

Correct medical billing requires knowledge of both clinical records and payer rules. A single incorrect code or missing authorization can lead to claim denial, late payment, and the need to later correct a patient’s statement.

This Medical Billing test will help you identify candidates who can code diagnoses at the correct level of detail, query physicians for incomplete documentation, navigate denied claims through the appeals process, and reconcile payments against an EOB.

Using the Medical Billing test, you can reserve your interview time for applicants who have already shown knowledge of the core billing skills. You can also reduce the risk of a mis-hire and see fewer coding and claims errors once the new hire joins your billing team.

You can bundle up to five tests into one assessment. Pair this one with other tests for the role, personality and work-style tests, or a cognitive ability (IQ) test, then finish with a structured interview and reference checks.

Job roles employers can hire using the Medical Billing test

The Medical Billing test is suitable for roles in which accurate coding, claims, and billing affect revenue and compliance:

• Medical billers prepare and submit claims, post payments, and follow up on unpaid balances.
• Medical coders translate physician documentation into standard diagnosis and procedure codes.
• Revenue cycle management (RCM) specialists oversee the path from patient registration to final payment and resolve the problems that slow it down.
• Billing and coding coordinators organize the daily work of billing teams and check that codes and claims meet payer requirements.
• Patient account representatives answer patient questions about statements, balances, and insurance coverage.
• Claims specialists review denied claims, prepare appeals, and track each case to resolution.
• Health information management (HIM) technicians maintain patient records and check that EHR documentation is complete and compliant.

About the Medical Billing test

Medical billing is the link between patient care and payment. Each service a patient receives must be documented, coded, and billed correctly so the provider is paid by the insurer or the patient.

Wetest’s Medical Billing test checks the operational knowledge and administrative judgment that billing, coding, and revenue cycle work require.

The test takes 10 minutes and covers three standard code sets:

• ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) for diagnoses
• CPT (Current Procedural Terminology) for procedures
• HCPCS (Healthcare Common Procedure Coding System) for items such as supplies and equipment

Candidates who know these code sets can assign the right codes the first time, which can mean cleaner claims and faster denial resolution for your practice.

What does the Medical Billing test measure?

The Medical Billing test assesses a candidate’s knowledge and judgment in four key areas of applied billing:

Coding principles:

• The ability to code using ICD-10-CM with specificity to the full detail of a condition, such as for a fracture or diabetes.
• Recognizing when to query a physician when their documentation is incomplete.
• Demonstrating the ability to establish medical necessity by using coverage guidelines to show a service matches the patient’s condition.

Claims management:

• Managing out-of-network denials.
• Undertaking peer-to-peer reviews (wherein the treating physician talks to the reviewer for the insurer) following an administrative appeal.
• Obtaining retroactive authorizations (insurer approval requested after a service is given).
• Understanding coordination of benefits, which determines the order in which insurers pay for patients with dual coverage.

Financial reconciliation:

• Balancing the bank deposits at the end of the day.
• Applying updates to the fee schedule.

Health information compliance:

• Validating data after records move to a new EHR.
• Handling patient access requests that contain sensitive information.
• Adhering to charting guidelines following a patient’s discharge.

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