Application form



Previous Experience Preferred

The Patient Account Representative must possess two years of  healthcare registration or billing experience; strong verbal and written communication skills and have the ability to discuss insurance billing with patients; able to manage work assignments to meet deadlines and detail-oriented.

Specialized or Technical Education Required

High school graduate or equivalent

Manual or Physical Skill Required

Physical Effort Required

Strength: Lights Push: Occasionally; Pull: Occasionally; Carry: Occasionally; Lift: Occasionally; Sit: Constantly; Stand: Occasionally; Walk: Occasionally


Personal Information

*All below fields are required.

Referral Information

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Placement Information

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High School

*All below fields are required.


Graduate School

Vocational School/ Other

Certifications / Licenses

License 1

License 2

License 3

License 4

Skills & Qualifications

Employment History

Current Employer

Previous Employer 1

Previous Employer 2


*All below fields are required.

Reference 1

Reference 2

Reference 3

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