The purpose of this supplemental questionnaire is to assist in determining if you meet the specified minimum qualifications of 2105 Patient Services Finance Technician. All applicants are required to complete the supplemental questionnaire as part of the online process. The information on the supplemental questionnaire must be consistent with the information on your online application. The supplemental questionnaire does not substitute for the online application. All statements are subject to verification.
Do not write "See Application" or "See Resume" as a response. Do not copy and paste your resume as a response.
1a.
How many months of verifiable experience performing medical charge reimbursement activities do you possess? (Note: 1 year of experience = 2000 hours of experience)
I do not have verifiable experience performing medical charge reimbursement activities
I have some experience but less than 1 year of verifiable experience performing medical charge reimbursement activities
I have 1 year but less than 2 years of verifiable experience performing medical charge reimbursement activities
I have 2 years but less than 3 years of verifiable experience performing medical charge reimbursement activities
I have 3 years or more of verifiable experience performing medical charge reimbursement activities
1b.
Which of the following duties have you performed? Check all that apply:
Reviewing and monitoring charges for patient services for completeness and accuracy
Reconciling medical records documentation
Assisting in the development, modification, and implementation of patient service charge procedures
Entering information into a computerized patient service charging and tracking database
Entering service charge codes into computer system
Performing clerical audits of medical records for appropriate documentation
Providing technical and clerical support, including support with clinical and financial issues for services
Completing encounter forms by marking service charge codes
I perform other duties
I do not have experience performing these duties
Please provide the following information for the experience you indicated in questions 1a. and 1b. above:
Name of employer(s) where the experience was obtained
Your Job Title/Position
Dates (MM/YYYY-MM/YYYY) and hours per week worked
Contact information of supervisor or manager who can verify the information
Please type N/A if you do not have experience
If you checked "other" to question 1b., please indicate what other medical charge reimbursement duties you have performed
Note: Please do not type "See Resume" or "See Attachment" as a response. Do not copy and paste resume. *Make sure that this experience is included on the application.
2.
Which of the following certificate(s) and/or degree(s) do you possess? Please check all that apply.
A recognized one (1) year Medical Assistant Certificate
A recognized two (2) year Medical Assistant Degree
A recognized certificate in Medical Office Management
Still attending, I will have my certificate or degree soon
I do not possess a certificate or degree
Other
Please provide the following information for the degree(s) or certificate(s) you possess:
Type of certificate(s) and/or degree(s)
Name of the school(s) that issued your certificate/degree
Please type N/A in the box below if this question does not apply to you
Note: Please do not type "See Resume" or "See Attachment" as a response. Do not copy and paste resume *Please make sure you provided this information in the education section of your application
CERTIFICATION: By checking this box, I hereby certify that I am the author of the information supplied in this supplemental questionnaire. I understand that any false or incorrect statements may result in my disqualification or dismissal from employment with the San Francisco Department of Public Health and the City and County of San Francisco. I also understand and agree that the information provided is subject to verification.
Department of Human Resources