Official SealSan Joaquin County Human Resources Division

Supplemental Questionnaire

Last Name
First Name

Graduation from an accredited four-year college or university with a major in business administration or public administration, health care management, accounting, social science, health science, or a closely related field is required.  Please indicate:

  1. Degree received
  2. Name of college or university and
  3. Major area of study


Two years of responsible experience performing hospital admitting, clinic registration, social service eligibility, or similar duties in an acute care hospital setting within the last five years, including at least one year in a supervisory capacity is required. 

When answering the following questions, please cite, 1) Job Title, 2) Name of Employer, 3) Dates of employment and 4) Hours worked per week.


Describe your supervisory experience in an acute care hospital setting within the last 7 years. Include in your response the number of staff supervised and the scope of your responsibilities.


Describe your experience performing one or more of the following functions in an acute care hospital setting within the last five years:

  • Hospital Admitting;
  • Clinic Registration;
  • Social Service Eligibility; and/or
  • Similar Duties related to the above area.

Describe your experience with health care insurance verification processes and third party reimbursement practices. If you do not have this experience, indicate "N/A" below.