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#TEX-9976-104665
Supplemental Questionnaire

Last Name
First Name
1

Which of the following current Epic Certification(s) do you hold? (check all that apply)

Resolute PB: professional billing
Resolute PB Claims: professional billing claims
Resolute HB: hospital billing
Resolute HB Claims: hospital billing claims
I Do Not have a current PB nor HB Epic Certification.
2

How many years of verifiable experience do you have in the information systems/technology field; which include system analysis, business process design, development or implementation of business application solutions or IT project management. (Choose One)

I have less than one (1) year of experience , equivalent to less than 2,000 hours.
I have at least one (1) year of experience, equivalent to at least 2,000 hours.
I have at least two (2) years of experience, equivalent to at least 4,000 hours.
I have at least three (3) years of experience, equivalent to at least 6,000 hours.
I have at least four (4) years of experience, equivalent to at least 8,000 hours.
I have at least five (5) or more years of experience, equivalent to at least 10,000 hours.
3

How many years of verifiable experience do you have  in Epic implementation & support? (Choose One)

Less than one (1) year of experience, equivalent to less than 2,000 hours.
At least one (1) year of experience, equivalent to at least 2,000 hours.
At least two (2) years of experience, equivalent to at least 4,000 hours.
At least three (3) or more years of experience, equivalent to at least 6,000 hours.
4

What is the highest level of education you have completed?  (Choose One)

An Associate degree from an accredited college or university OR its equivalent.
An Bachelor's degree from an accredited college or university OR its equivalent.
An Juris Doctor (J.D.) degree from an accredited college or university OR its equivalent.
An Master's degree from an accredited college or university OR its equivalent.
An Doctoral degree from an accredited college or university OR its equivalent.