Admissions Application

Be honest. We want you to succeed.

Completion Progress 0%

Your Information

Let's start with the basics

First Name *

Last Name *

Email *

Phone *

Life Fit

Let's see if the timing works

Are you currently employed?

Full-time Part-time Unemployed Self-employed

How many hours per week can you commit?

Less than 10 (Not recommended) 10-15 15-20 20+

Do you have consistent access to a computer and reliable internet?

Yes No

Do you have a quiet space to attend live sessions and study?

Yes No

Career Intent

What are you actually trying to do?

What's your primary goal?

Enter medical claims/reimbursement roles Advance in healthcare operations Transition into audit/compliance Explore healthcare data roles Not sure yet

Why is this the right time for you? *

What changes if you succeed? *

What happens if you DON'T take action in the next 6 months? *

Technical Readiness

Can you handle the basics?

Which best describes your computer skills?

I struggle with basic tasks I can use email and browsers I'm comfortable with multiple apps I'm very confident

Can you do these WITHOUT help?

Send/receive email Join Zoom/Teams Upload/download files Use Google Docs/Word Navigate multiple browser tabs

Do you regularly use keyboard and mouse?

Yes No

How would you describe your typing speed?

Fast Average Slow Very slow

Can you type forms and data entry for 1-2 hours straight?

Yes no problem Yes but need breaks That sounds difficult No I can't

Learning Style

How do you learn best?

When learning something new, you usually:

Need step-by-step guidance Learn best by practice Prefer reading/watching first Figure things out independently

If you don't understand something right away:

Give up Wait for help Research it Ask questions and keep trying

How comfortable are you with detailed rules and policies?

Very uncomfortable Somewhat uncomfortable Neutral Somewhat comfortable Very comfortable

Which sounds most like you?

I like clear instructions Solving problems Analyzing details Improving systems

Coachability

This is the big one

When you receive constructive feedback:

Feel discouraged Take it personally Reflect and adjust Appreciate it

Have you completed a demanding training or certification before?

Yes No

If you fall behind:

Quit Hope it fixes itself Ask for support Create a catch-up plan

Are you willing to be held accountable for deadlines and performance?

Yes No

Education & Compliance

Basic requirements

Highest education completed:

High school/GED Some college Associate Bachelor's or higher

Can you read and write professional emails and reports in English?

Yes No

Do you agree to uphold ethical and compliance standards in healthcare?

Yes No

Commitment

The final question

I understand and agree: "This program is fast-paced and requires consistent effort. Your success depends on your participation and discipline." I do not agree

Why should we accept you into this class? *

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Application Received

Thank you for applying to PastDue Academy's Fast Track Medical Claims 101 program.

Our admissions team will review your application and reach out within 48 hours.

In the meantime, follow us on social media for healthcare career tips.

Visit pastdueacademy.com Contact us at info@pastdueacademy.com

PastDue Academy | A division of GGenesis Strategic Solutions

pastdueacademy.com | info@pastdueacademy.com