Official SealSan Joaquin County Human Resources Division


#0719-RO6115-02
Supplemental Questionnaire

Last Name
First Name
1

Pattern I: Do you possess at least one year of full-time experience at a level equal to or higher than a Senior Office Assistant in San Joaquin County service which included insurance credentialing duties in a medical or healthcare setting?
Yes No
 

If you responded yes, please provide the following information in the space below:

  • Job Title
  • Dates of Employment
  • Number of Hours worked per week
  • Description of insurance credentialing duties performed
2

Pattern II: Do you possess at least 3 years of general clerical, secretarial and/or office technical work, including at least one year functioning at a full journey level performing insurance credentialing duties in a medical or healthcare setting?
Yes No
 

If you responded yes to the previous question for Pattern II, please answer the following questions.  If you do not possess the experience, please indicate "N/A"

Include in your response the following information:

  • Job Title
  • Dates of Employment
  • Number of hours worked per week
  • Name of medical or healthcare setting
  • Specific insurance credentialing duties performed