Clone of Billing Coordinator Job Application Form

Part-Time Billing Coordinator Application

Please complete the application below in full. This role has a fixed schedule and specific requirements. Only applicants who meet the listed qualifications and availability will be considered.
Applicant Information
Full Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Role Schedule & Availability

This role has a fixed schedule and requires candidates to be local to the Dallas–Fort Worth area. Please review carefully before applying.
Are you available to work Monday through Friday from 11:00 a.m. to 5:00 p.m. CST.?
Are you currently based in the DFW metroplex?
Are you legally authorized to work in the U.S.?
Billing & Financial Experience
How many years of billing, invoicing, or financial operations experience do you have?
Which tasks have you handled? (Select all that apply)
Which billing or CRM platforms have you used?
Why are you interested in the Billing Coordinator role with our company?
Describe a time you had to learn a new system quickly. How did you approach it?
Job Alignment
Do you have a high level of attention to detail and accuracy, especially in managing contracts and financial documents?
Can you work independently with minimal supervision and also effectively collaborate as part of a team?
Which of the following tools have you used regularly in a professional setting? (Select all that apply)
On a scale of 1-10, what is your Excel experience?
(e.g., 1 = basic, 10 = advanced formulas)
Are you skilled in both written and verbal communication, with a strong focus on customer service?
Do you possess strong organizational and time-management skills, capable of effectively prioritizing tasks?
Compensation & Training
This role pays $20-27 per hour. Are you comfortable with this pay rate?
This position is paid monthly, with payment issued on the 15th of each month. Are you comfortable with this pay schedule?
Are you available to travel internationally at least once per year for on-the-job trip training alongside clients?
Resume Upload
Please upload your resume. By uploading your resume, candidates consent to review their information can help with compliance and clarity.

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Referral Source
Where did you hear about us?
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Part-Time Billing Coordinator Application

Applicant Information

Role Schedule & Availability

Billing & Financial Experience

Job Alignment

Compensation & Training

Resume Upload

Referral Source