Exempt to Permanent - Hospital Eligibility Worker (2903) Citywide (E10161)

City and County of San Francisco•San Francisco, CA

14d

About The Position

THIS IS A CITYWIDE RECRUITMENT FOR CURRENT CITY EMPLOYEES ONLY. This is an Exempt to Permanent recruitment. Only currently active, exempt employees of the City and County of San Francisco in this recruitment’s classification will be placed on the eligible list for consideration of future permanent positions. San Francisco is a vibrant and dynamic city, on the forefront of economic growth & innovation, urban development, arts & entertainment, as well as social issues & change. This rich tapestry of culture and ideas is sustained by our City's commitment to heighten the quality of life for the diverse population of San Franciscans and residents of the greater Bay Area. Our employees play an important role not only in making our City what it is today, but also in shaping the future of San Francisco. Under general supervision, performs a variety of technical duties in the screening, determination of patient eligibility, and enrollment for medical coverage under the terms of various private and public health care and financial assistance programs. Essential functions of the 2903 Hospital Eligibility Worker include, but are not limited to: Interviews patients, their relatives, and others to obtain financial and demographic information and determines eligibility for coverage of medical care under various Federal, State, or County programs or under the provisions of private or public health care plans; verifies insurance and arranges for billing of the appropriate agency or health care plan. Admits and registers patients for clinic and hospital services; initiates referrals for incoming skilled or long-term care patients. Coordinates transfers of patients between medical facilities; informs patients of procedures and necessary reports. Explains eligibility programs, qualification standards, policy, and procedure to patients; assists patients in completion of applications, forms and reports when necessary; reviews and evaluates applications for completeness and accuracy; prepares patient budget to determine eligibility. Prepares records related to patient eligibility information and financial assistance received; updates records; submits required reports. Investigates statements and information received from the applicant through the use of telephone or written verifications. Investigates and resolves patient questions and concerns regarding clinic and hospital bills. Reviews cases with the supervisor in assessing the quality of the payment source determination process and procedure. Composes and prepares correspondence to patients, references, and State agencies; gathers statistical data and prepares reports as required. Answers questions and provides information to patients and the general public regarding the assigned program area. 2903 Hospital Eligibility Worker performs related duties as assigned/required.

Requirements

Current Category 16, 17, or 18 Exempt Employee in Class 2903 who has worked at least 2,080 hours in class 2903; AND
Two (2) years of direct public contact clerical work experience, which must have included ALL of the following: use of computer applications to input, retrieve, and analyze information; working with a diverse client population; performing responsibilities involving interviewing to acquire detailed personal or confidential information; interpreting and applying rules, regulations, and policies; creating and processing documents related to the financial or personal histories of clients; and assisting clients with the completion of forms or correspondence; OR
One (1) year of experience determining eligibility for health and/or social services programs, loans, financial assistance, unemployment, or veterans benefits OR
Sixty (60) semester units or ninety (90) quarter units from an accredited college or university.
Substitution: Thirty (30) semester units or forty-five (45) quarter units from an accredited college or university may substitute for one (1) year of the work experience under qualification pattern number one (1) above.
Some positions may require bilingual fluency in a variety of languages, depending upon the department's bilingual needs. Only those eligible candidates who pass the bilingual proficiency test will be considered for bilingual positions. Applicants must indicate on the application form the language(s) in which they claim proficiency.
Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.
One year of full-time employment is equivalent to 2,000 hours of qualifying work experience (one year if performed full-time at 40 hours per week).

Responsibilities

Interviews patients, their relatives, and others to obtain financial and demographic information and determines eligibility for coverage of medical care under various Federal, State, or County programs or under the provisions of private or public health care plans; verifies insurance and arranges for billing of the appropriate agency or health care plan.
Admits and registers patients for clinic and hospital services; initiates referrals for incoming skilled or long-term care patients.
Coordinates transfers of patients between medical facilities; informs patients of procedures and necessary reports.
Explains eligibility programs, qualification standards, policy, and procedure to patients; assists patients in completion of applications, forms and reports when necessary; reviews and evaluates applications for completeness and accuracy; prepares patient budget to determine eligibility.
Prepares records related to patient eligibility information and financial assistance received; updates records; submits required reports.
Investigates statements and information received from the applicant through the use of telephone or written verifications.
Investigates and resolves patient questions and concerns regarding clinic and hospital bills.
Reviews cases with the supervisor in assessing the quality of the payment source determination process and procedure.
Composes and prepares correspondence to patients, references, and State agencies; gathers statistical data and prepares reports as required.
Answers questions and provides information to patients and the general public regarding the assigned program area.
2903 Hospital Eligibility Worker performs related duties as assigned/required.