Official SealSan Joaquin County Human Resources Division


#0320-RM0205-AC
Supplemental Questionnaire

Last Name
First Name
1

Indicate the highest level of education achieved:

(Ensure that this information is clearly identified in the Education section of the application)

I possess a master's degree from an accredited college/university
I possess a bachelor's degree from an accredited college/university
I possess an associate's degree from an accredited college/university
I do not possess any of the above
1a

Indicate the major/emphasis of the degree obtained.

Business/Public Administration
Accounting
Economics
Finance
Mathematics
Health Science
Other - related field
1b

If "Other" was selected, please provide the major/emphasis of the degree obtained.

1c

Provide the accredited college/university attended.


 

When responding to the following questions, please provide the following information:

  • Job Title
  • Name of Employer
  • Dates of Employment
  • Hours Worked Per Week

If you do not possess experience, respond with "n/a".


2

Provide your experience with directly supervising billing and follow-up functions for at least three of the following payors:  Medi-Cal, Medicare, Commercial and Contract Insurance, Third Party Liability, and Self-Pay collections.  Include in your response the number of employees you directly supervised and the functions staff performed.

Note that this experience must be in a hospital setting and within the last five years.

3

Describe your experience developing quality control and improvement programs for a Business Office. Include your role and contribution in the process.

4

Describe your experience managing the revenue cycle activities in an acute care hospital setting.