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#0321-RH0130-01
Supplemental Questionnaire

Last Name
First Name

 

There are two experience minimum qualifications patterns under which you may qualify for the position.


1.

Experience:  Pattern I requires one-year equivalent to a Medical Records Technician III in San Joaquin County.

Do you have work experience as listed above in San Joaquin County? If yes, identify the following:

  • Name of the department in San Joaquin County
  • Employee ID number
  • Position title
  • Timeline of employment
1b.

Do you possess at least six (6) months experience performing primary duties of a medical coder in a Hospital Medical Records environment?  If yes, identify the following:

  • Name of the hospital
  • Position Title
  • Type of coding performed
  • Timeline of employment
  • Average hours worked per week
2.

Experience Pattern II requires two years of journey level experience in an acute care hospital, mental health inpatient facility, skilled nursing facility, or large group-practice/medical clinic, coding diseases and operations using the standard classification system, at least six months of which must have been in a lead or supervisory capacity.

Do you have this advanced level work experience as listed above gained from an acute care hospital, mental health inpatient facility, skilled nursing facility, or large group practice/medical clinic? If yes, identify the following:

  • Name of employer
  • Type of facility
  • Position title
  • Coding duties performed
  • Timeline of employment
  • Average hours worked per week
2a.

Do you possess at least one year experience performing primary duties in the role of a Medical Records Coder?  If yes, identify the following:

  • Name of employer
  • Position title
  • Type of coding performed
  • Timeline of employment
  • Average hours worked per week
3.

Describe your experience leading or supervising staff performing coding of diseases and operations using the standard classification system. Identify the number of staff you lead or supervised, what your scope of responsibilities were and what topic areas of training did you provide.

4.

Describe your experience performing coding of diseases and operations using the standard classification system. Include in your answer: The medical record systems you worked with, the volume of coding conducted, and the classification system(s) you have experience with.

5.

In addition to meeting the experience minimum qualifications, you must meet the License & Certificates minimum qualifications as well.

This position requires possession of either a Registered Health Information Technician certificate (RHIT) or Registered Health Information Administrator (RHIA) certificate issued by the American Health Information Management Association.

Do you possess either the RHIT or RHIA certificate as stated above?

Yes No
6.

If you answered "yes", indicate whether the certificate is RHIT or RHIA, the certificate number, and date certification obtained.

Note: Your certificate will be verfied with the American Health Information Management Association (AHIMA).

7.

If you answered "no" above, have you successfully completed an approved health information management (HIM) program for Registered Health Information Technicians?

Yes No
8.

If "yes", please state the name of the school, program name and your anticipated graduation date.

9.

Candidates that qualify under substitution pattern of completion of a HIM Program must obtain certification as a Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) within one year of completion of the program. Do you understand and accept this as a condition of employment?

Yes No
10.

Do you possess experience with developing or performing tasks under Clinical Documentation Improvement (CDI) programs? If yes, identify the following:

  • Name of employer
  • Position title
  • Types of programs you implemented or worked with
  • Detailed tasks performed
  • Timeline of employment
  • Average hours worked per week
11.

Do you possess experience utilizing ChartWise CDI software or any similar software program? If yes, identify the following:

  • Name of CDI software you possess experience with
  • Experience timeline
  • Proficiency level (novice, intermediate or advanced)

If you possess no experience with CDI software, annotate N/A.