Medical coder interview questions and how to answer them
Coding interviews are tests with a conversation attached. Most remote employers send a coding assessment first (often 20-50 charts or scenario questions, open book), then a call with a coding manager who asks you to explain your choices.
The questions below mix the technical ones you'll be scored on with the remote-work questions offshore employers always ask.
Updated October 2026 by the WorkRemote careers team
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About the role and your experience
Openers that check you understand the job and have done the work.
When do you query a provider, and how do you word it?
Why they ask
Leading queries are a compliance problem; never querying is a quality problem.
How to answer
Query when documentation is conflicting, incomplete or unclear. Keep it neutral, give clinical indicators, offer options including "other" and "unable to determine". Never mention payment.
What accuracy and productivity have you achieved?
Why they ask
Remote coders are managed by numbers.
How to answer
Give your audit score and charts per hour, and say what type of chart. If you're new, give practice results and be honest.
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On radiology and E/M charts I was averaging about 18 charts an hour with 96% on my last two quarterly audits. On surgery charts I'm slower, around six an hour, and I'd expect to build that up.
How do you keep up with code changes?
Why they ask
ICD-10-CM changes every October and CPT every January. Out-of-date coders cost money.
How to answer
Name what you actually do: AAPC or AHIMA updates, the CMS ICD-10 files, CEU webinars, Coding Clinic. Mention the CEUs needed to keep your credential.
Technical questions
What you know and how you'd do the work, often with a live task or test.
Which code sets do you use, and when?
Why they ask
A basic filter for whether you know outpatient from inpatient work.
How to answer
ICD-10-CM for diagnoses everywhere; CPT and HCPCS Level II for outpatient and physician services; ICD-10-PCS for inpatient procedures. Say which you've used most.
How do you level an office E/M visit under the current guidelines?
Why they ask
E/M is a large share of pro-fee work and a frequent audit target.
How to answer
Explain that since 2021 office visits are levelled by medical decision-making (problems, data, risk; two of three) or by total time on the date of the encounter. Give an example.
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I'd score MDM first. Say a patient with two stable chronic conditions, where the doctor reviews labs and adjusts a prescription drug: that's moderate problems and moderate risk, so 99214 for an established patient, unless documented time supports a higher level.
What's the difference between Excludes1 and Excludes2?
Why they ask
Shows you've read the guidelines, not just practised with an encoder.
How to answer
Excludes1: the two conditions can't be coded together (with a few stated exceptions). Excludes2: the condition isn't part of this code, but the patient can have both, so you may code both.
The note says "probable pneumonia" for an outpatient visit. How do you code it?
Why they ask
Uncertain diagnoses are handled differently in outpatient and inpatient settings, and people mix them up.
How to answer
Outpatient: don't code uncertain diagnoses; code the signs and symptoms (cough, fever). Inpatient: uncertain diagnoses documented at discharge can be coded as if confirmed. Mention the setting matters.
What are NCCI edits and how do you handle one?
Why they ask
Unbundling is a common denial and compliance risk.
How to answer
Procedure-to-procedure edits show code pairs that shouldn't be billed together; MUEs limit units. If the services really were separate and documented, a modifier like 59 or an X modifier may apply. If not, you bundle.
Explain HCCs and the MEAT criteria.
Why they ask
Risk adjustment is one of the most common remote coding jobs.
How to answer
HCCs group diagnoses that predict cost for Medicare Advantage risk scores. A condition counts only if the record shows it was monitored, evaluated, assessed or treated in a face-to-face visit that year. Give an example of a diagnosis you would not capture.
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If the problem list says "history of CHF" but the note never mentions it, no meds, no exam findings, no plan, it doesn't meet MEAT and I wouldn't code it, even though it would raise the risk score.
What do you know about HIPAA's minimum necessary rule?
Why they ask
Offshore coders see full patient records; clients need to trust you.
How to answer
Access only the information you need for the task, don't browse other records, and don't share PHI outside approved systems. Describe how you'd apply it day to day.
Behavioural questions
Past situations. Answer with a real example: what happened, what you did, what changed.
Tell me about an audit finding you disagreed with.
Why they ask
Shows how you handle feedback and whether you back your choices with guidelines.
How to answer
Pick a real case, say what guideline or Coding Clinic reference you cited, and what happened. It's fine if you turned out to be wrong; say what you learned.
You hold a CPC-A. Why should we hire you over an experienced coder?
Why they ask
Every new coder hears this question in some form.
How to answer
Don't pretend to be experienced. Point to what lowers the risk: clinical background, practice chart volume, exam score, willingness to start on 100% audit.
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I'm a registered nurse with six years on a surgical ward in Lagos, so operative notes and drug names aren't new to me. I passed the CPC on my first attempt and I've coded about 600 practice charts. I'm happy to start on 100% audit until you're comfortable.
Situational questions
Hypotheticals about problems you'd meet in the job.
A doctor's note supports a lower code than the one already on the encounter. What do you do?
Why they ask
Tests integrity under pressure to keep revenue up.
How to answer
Code what's documented. If the provider might have done more than they wrote, send a compliant query. Escalate through your lead if someone pushes you to code what isn't there.
How would you code a chart where the documentation is copied forward from earlier visits?
Why they ask
Cloned notes are common and auditors challenge them.
How to answer
Code only what is supported for this encounter, look for evidence the condition was addressed today, and flag the pattern to your lead or CDI team rather than coding everything in the copied text.
Remote work questions
How you'll work from Nigeria with a team elsewhere: hours, power, internet, communication.
How do you set up your workspace for remote coding from Nigeria?
Why they ask
They want to know you'll be online, secure and focused for a full shift.
How to answer
Dedicated laptop, two monitors if you have them, VPN, closed room, backup power and a second internet line. Name your actual setup.
Our coders overlap four hours with US Eastern. Which hours would you work?
Why they ask
Coding is often flexible, but they need you reachable for queries and huddles.
How to answer
Convert it: 9am-1pm Eastern is 2pm-6pm in Lagos (3pm-7pm when the US is on standard time). Propose a schedule around that overlap and stick to it.
Remote interview tips
Treat the coding test like the CPC exam: have your books tabbed, read the instructions on whether you may use an encoder, and manage your time. Many tests are timed but open book.
In the interview, talk through your logic out loud with guideline references. "Per section I.C.4 I'd sequence the diabetes first" sounds like someone who codes; "I think it's this one" doesn't.
If you're a CPC-A, say so plainly and show your plan to remove the apprentice tag. Employers dislike surprises when they check the AAPC credential directory.
Questions people ask
Do remote medical coding jobs give a test?
Almost all do. Expect an online assessment of real or mock charts, usually open book, before any interview with the coding manager.
What should I study before a coding interview?
The ICD-10-CM official guidelines (especially sequencing and uncertain diagnoses), E/M levelling, modifiers 25 and 59, NCCI edits, and the specialty in the job ad. Risk adjustment roles will also ask about HCCs and MEAT.
Will they check my certification?
Yes. AAPC and AHIMA credentials can be verified, and employers do check if you hold a full CPC or a CPC-A.
Can I interview for US coding jobs from Nigeria?
Only for roles that accept international contractors or offshore staff. Read the location requirement first; many US remote coding jobs only hire people living in the US.
Updated October 2026 by the WorkRemote careers team
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