Ancillary Charge Specialist

Customer Service/Insurance Services Dubuque, Iowa

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Job Description Acknowledgement

By selecting Yes, I confirm that I fully understand all essential job functions as outlined in the job description; including the physical requirements and that I am able to perform those essential job functions with or without accommodations. I also understand that my ability to perform those essential job functions, including the physical requirements will be evaluated at a pre-employment physical exam if hired. If you selected No, please contact Human Resources.

I have reviewed the job description and physical requirements for this position. I understand that duties, hours, wages, benefits, and reporting relationships are subject to change at Medical Associates’ discretion and that employment is at-will.*

If you are offered a position at Medical Associates, offers are contingent upon successful completion of a background check and a pre-employment physical and drug screening test. Please review the statements below and indicate your understanding and agreement: 1. I authorize Medical Associates to obtain and use a consumer and/or investigative consumer report for employment purposes. That may include information as to my character, general reputation, personal characteristics, mode of living, work experience and performance, along with reasons for termination of past employment. The report may also contain records check of driving, criminal, credit, education, degrees, professional licenses and/or certification records depending on the position. 2. I understand that if hired, I will be required to complete a pre-employment physical and drug screening test, including the collection, and testing of a blood and/or urine sample and my offer may be rescinded if I fail a drug screen. 3. I affirm that the information provided on this application (and accompanying résumé, if any) is true and complete to the best of your knowledge, and acknowledge that falsified information or significant omissions may disqualify me.

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