Official SealSan Joaquin County Human Resources Division


#1021-RO1010-AC
Supplemental Questionnaire

Last Name
First Name

1

To qualify, you must possess three years of experience performing insurance billing, collections, or accounts receivable in a hospital environment within the last five (5) years.


1a
If you responded yes, please identify your title, specific duties and responsibilities (i.e. insurance billing, collection, or accounts receivable), identify your employer (the hospital or clinic environment in which you worked), and the hours worked per week.