0923 MANAGER II - Director of Coding (PBT-0923-083930)
SUPPLEMENTAL QUESTIONNAIRE
PLEASE READ THE FOLLOWING INSTRUCTIONS CAREFULLY
The purpose of the Supplemental Questionnaire is to determine whether you meet the Minimum Qualifications for the 0923 Manager II – Director of Coding position. Specifically, your responses will be used to assess possession of the required education, license, and experience for the 0923 Manager II – Director of Coding position.
It is suggested that you allow ample time to submit your application and Supplemental Questionnaire responses before the filing deadline. If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with the information on your employment application and are subject to verification.
1.
Please select the highest level of education that you have completed.
High School Diploma or equivalent
Associate's degree
Bachelor's degree
Master's degree
Doctoral degree
None of the above
Please list the school(s) where you obtained your degree(s) as well as the type of degree earned (e.g. Bachelor of Arts degree in Liberal Studies from San Jose State University). If you do not possess any of the degrees identified above, type N/A.
2a.
Do you have a valid certificate issued by the American Health Information Management Association (A.H.I.M.A.)?
Yes
No
2b.
Please identify all of the valid A.H.I.M.A. certificates that you possess:
Registered Health Information Technician (R.H.I.T.)
Registered Health Information Administrator (R.H.I.A.)
Certified Coding Specialist (C.C.S.)
None of the above
2c.
If you answered that you possess a valid certificate in #2a or #2b above, please identify the type of certificate (e.g. R.H.I.A., R.H.I.T., or C.C.S.), your certificate number, your name as it appears on your certificate, and the expiration date of your certificate. If you do not possess a certificate as identified above, type N/A.
3a.
How much professional hospital coding experience do you have?
I do not have any experience
I have less than 6 months of experience
I have at least 6 months, but not more than 11 months of experience
I have at least 12 months, but not more 23 months of experience
I have at least 24 months, but not more 35 months of experience
I have at least 36 months, but not more 47 months of experience
I have at least 48 months, but not more 59 months of experience
I have 60 months of experience or more
3b.
Was the professional hospital coding experience referenced in #3a above acquired in a hospital that provides 24 hour acute/inpatient and outpatient/ambulatory care, including the following basic services: Medical, Nursing, Surgical, Anesthesia, Laboratory, Radiology, Pharmacy, and Dietary Services?
Yes
No
In accordance with your responses to #3a and #3b above, please provide the name of the employer(s) and the dates (e.g. MM/YYYY – MM/YYYY) where you obtained the verifiable full-time equivalent work experience.
Additionally, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you do not have experience in these areas, please type N/A.
I understand that checking this box will serve as my electronic signature. I certify that I am the author of this questionnaire and all information presented is true and based upon my education, training, skills, and experience. I understand and agree that any information provided is subject to verification. I also understand that any false, incomplete, or incorrect statement may result in disqualification, termination, or dismissal from employment with the City and County of San Francisco.
Department of Human Resources