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#17-004524-0003
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1.

Are you a current employee of the Maryland Department of Health and Mental Hygiene's Division of Cost Accounting and Reimbursements (DCAR)?

Yes No
2.

Do you have at least six (6) months of experience involving the analysis of claims submitted utilizing the Hospital Management Information System (HMIS)?

Yes No
3.

If you answered "Yes" to the previous question, please describe this experience in the field below. What was your job title in performing these duties and list the name of the employer, employment dates, and hours worked per week.  If you do not have this experience, please enter N/A.

4.

Describe your customer service skills.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

5.

Describe your experience in a health care setting and/or insurance company.

With your description, include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  This experience must also be reflected in the "Work Experience" section of your application.  If you do not have this experience, put N/A in the box below.

6.

Please describe your experience using Microsoft Excel and Word. Please explain in detail your knowledge and experience including dates and places of employment. If you do not possess this experience, please answer N/A.

7.

Describe any lead or supervisory experience that you possess.

Please include name of employer, job title, dates of employment, and hours worked per week.  This information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.


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