Official SealSan Joaquin County Human Resources Division


#1122-RO4130-01
Supplemental Questionnaire

Last Name
First Name
1.

Do you possess two years experience performing medical staff credentialing functions?

Yes No
2.

Do you possess two years (paid full-time) experience providing administrative clerical support to medical and/or management staff in a health care environment?

Yes No

 

If yes, please ensure this is CLEARLY demonstrated in the Employment Experience section of the application. 


3.

Do you possess a valid Certified Provider Credentialing Specialist certificate issued by the National Association of Medical Staff Services (NAMSS)?

If yes, include a copy with your application. 

Yes No

 

Please ensure this is CLEARLY indicated in the Professional Licenses, Certifications, or Registrations section of your application. 


4.

Do you possess an Associate's Degree in Business Administration or a related field?

Yes No

 

Please ensure this is CLEARLY indicated in the Education section of your application.


5.

Do you possess a valid California Class C driver's license?

Yes No

 

Please ensure this is CLEARLY indicated in the Driver's License section of your application.