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#20-000463-0002
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

If substituting experience in health care financing work or the life/health insurance fields in the investigation and/or adjustment of claims for the educational requirement, please upload transcript to application (unofficial versions of transcript(s) acceptable).


2

Describe your experience in health care financing work or the life/health insurance fields in the investigation and/or adjustment of claims.

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.

3

Describe, in detail, your experience providing customer service in an office setting.  If you do not have this experience, indicate N/A.

4

Describe your experience working with computers and different software including Microsoft Office and entering data into a data base system. If you do not have this experience, please mark N/A.

5

Please describe your experience in composing correspondence via email and memorandums. 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.

6

Describe your professional oral and written communication skills. Please include name of employer, job title, dates of employment, and hours worked per week. If you do not have this type of skill, please write N/A.


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