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#CBT-2909-903544
Supplemental Questionnaire

Last Name
First Name

 

2909 Hospital Eligibility Worker Supervisor (CBT-2909-903544)

The purpose of this Minimum Qualification Supplemental Questionnaire (MQSQ) is to obtain specific information regarding your education and experience in relation to the minimum qualifications for the recruitment, as stated on the announcement and will be used as a tool to screen applications for minimum qualification requirements. This Minimum Qualifications Supplemental Questionnaire (MQSQ) must be completed and submitted online with the application at the time of filing. Responses to items on the MQSQ must be supported by the information provided on the application in order to receive appropriate credit. Please be sure to include ALL relevant education and experience in the work history and education sections of the application. The information provided must be consistent with the information on your application and is subject to verification.  Verification may be requested at any time.

Applicants who do not possess the required Minimum Qualifications as stated on the job announcement will not be allowed to participate in the selection process.

Note: Falsifying one's education, training, or work experience or attempted deception on the application or MQSQ may result in disqualification for this and future job opportunities with the City and County of San Francisco. 

 
1.

How much verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker), within the last Five (5) years, do you have in a hospital determining eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement?

As a reminder, ALL qualifying experience must be listed on the application in order to be considered in review of Minimum Qualifications. If you do not include the work experience you are about to describe in the experience section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update the education and work history section before submitting your application.
I have less than one year (less than 2,000 hours) of verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker) determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement within the last five (5) years.
I have at least one year (minimum 2,000 hours) but less than two years (4,000 hours) of verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker) determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement within the last five (5) years.
I have at least two years (minimum 4,000 hours) but less than three years (6,000 hours) of verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker) determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement within the last five (5) years.
I have at least three years (minimum 6,000 hours) but less than four years (8,000 hours) of verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker) determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement within the last five (5) years.
I have at least four years (minimum 8,000 hours) but less than five years (10,000 hours) of verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker) determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement within the last five (5) years.
I have five years (minimum 10,000 hours) or more of verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker) determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement within the last five (5) years.
I do not have any verifiable work experience (equivalent to the work performed by a class 2908 Senior Hospital Eligibility Worker) determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement within the last five (5) years.
 

CERTIFICATION: By checking this box, I hereby certify that I am the author of the information supplied in this supplemental questionnaire.  I understand that any false or incorrect statements may result in my disqualification or dismissal from employment with the San Francisco Department of Public Health and City and County of San Francisco.  I also understand and agree that the information provided is subject to verification.