Senior Hospital Eligibility Worker (2908) - DPH - H00129

The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status.

• Application Opening – Friday, November 22, 2024
• Application Deadline – Application filing will close on or after Friday, December 6, 2024
• Salary: $88,816 - $108,004 annually
• Appointment Type: Permanent Civil Service
• Recruitment ID: CBT-2908-H00129

The Mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. SFDPH strives to achieve its mission through the work of multiple divisions - the San Francisco Health Network, Population Health, Behavioral Health Services, and Administration. The San Francisco Health Network is the City’s only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Population Health Division (PHD) provides core public health services for the City and County of San Francisco: health protection, health promotion, disease and injury prevention, and disaster preparedness and response. Behavioral Health Services operates in conjunction with SFHN and provides a range of mental health and substance use treatment services.

This is a Class-Based Test administered in accordance with Civil Service Rule 111. The eligible list resulting from this Class-Based Test (CBT) Announcement will be used to fill vacancies in this class.

Under general supervision, the Senior Hospital Eligibility Worker performs financial counseling, screening, and enrollment for medical coverage under the terms of various private and public healthcare and financial assistance programs, including Medi-Cal and Medicare to maximize hospital reimbursement and facilitate patient care. Depending on the position location, duties may vary. The essential functions include:

1. Interviews patients, their relatives, and others to identify and determine patient eligibility for coverage of medical care under various Federal or State programs, private or other healthcare plans;
2. Counsels patients about eligibility, billing policies, reimbursement programs, qualification standards, procedures, and payment options;
3. Investigates payor requirements by obtaining benefits information, notifies insurance plans of patients' treatment needs;
4. Assists patients and their representatives to apply for Medi-Cal, California Children Services, and other Federal, State, and County reimbursement programs;
5. Assists in registering patients into the hospital;
6. Communicates accurate financial reimbursement information and eligibility verification to healthcare professionals to aid in treatment planning;
7. Enters patient data into hospital database and into computer programs to set up billing accounts for patients, file monthly reports, write correspondence, track production, and update patient accounts;
8. Prepares, updates, and maintains records related to patient eligibility information and health care payment received. Determines patient eligibility for third-party payment sources according to established policies and procedures, including private health insurance plans, victims of crime, worker’s compensation, and lawsuit settlements;
9. Maintains resource materials regarding regulations and procedures, procedural memos, and training material and keeps current with changes in laws, policies, and procedures;
10. Prepares patient budget to determine eligibility for coverage of medical care; and
11. Regulates patient finances to maintain patient eligibility and entitlement to various benefits; facilitates burial arrangements and final disposition of patient estate.

The Senior Hospital Eligibility Worker performs other related duties as required/assigned.

Shift(s): Variable depending on position location. Days, evenings, nights, weekends, and/or holiday shifts may be required. Hospitals are open twenty-four (24) hours, seven (7) days per week

1. EXPERIENCE: Two (2) years of experience performing the duties of an Eligibility Worker in a hospital, medical clinic, Medi-Cal unit, or a community-based health organization. 
   • The work experience must include determining eligibility for various Federal, State, and county programs that reimburse for medical care.
2. License and Certification: Must obtain Certified Enrollment Counselor Certification for Covered California and pass federal background check within 3 months of hire.

Special Conditions - In addition to the listed minimum qualifications, some positions may require special conditions, including but not limited to:

• Bilingual Proficiency: 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 fulltime employment is equivalent to 2,000 hours (2,000 hours of qualifying work experience is based on a 40-hour work week).

Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities. 

Selection Procedures: 
After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following.

Minimum Qualification Supplemental Questionnaire (MQSQ): Candidates will be required to complete an MQSQ as part of the employment application. This MQSQ is designed to obtain specific information regarding an applicant's experience in relation to the Minimum Qualifications (MQ) for this position. The MQSQ will be used to evaluate if the applicant possesses the required minimum qualifications.

Written Multiple-Choice Examination (Weight: 100%)
Candidates that meet the minimum qualifications will be invited to participate in the Written Examination that is designed to measure the knowledge, skills, and abilities in job related areas which may include but not be limited to:

• Knowledge of Federal, State & County Health Programs; Knowledge of the principles and techniques of interviewing; Knowledge of basic arithmetic; Ability to interpret rules, regulations, and policies; Decision-making ability; Human relations/customer service ability; Written communication; and/or Organizational and record keeping skills

Candidates must achieve a passing score on the Written Multiple-Choice Examination in order to continue in the selection process and will be placed on the confidential eligible list in rank order according to their final score.

This is a standardized examination; therefore, test questions and test answers are not available for public inspection or review.

Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

Certification
The certification rule for the eligible list resulting from this examination will be the Rule of Ten Scores.

Eligible List/Score Report:
Once you pass the exam, you will be placed onto an eligible list and given a score and a rank. For more information, visit https://careers.sf.gov/knowledge/process/

The duration of the eligible list resulting from this examination process will be 12 months and may be extended with the approval of the Human Resources Director.

How to apply:

Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process. 

Our e-mail communications may come from more than one department so please make sure your email is set to accept messages from all of us at this link. Applicants must ensure that email from CCSF is not blocked on their computer by a spam filter. 

Applicants may be contacted by email about this recruitment therefore, it is their responsibility to contact the Analyst if they update their email address. 

Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received.

Terms of Announcement and Appeal Rights:
Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state or local laws, rules or regulations. [Note: The correction of clerical errors in an announcement may be posted on the Department of Human Resources website at https://careers.sf.gov/. The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S Van Ness Avenue, 4th Floor, San Francisco, CA 94103-5413 by close of business on the 5th business day following the issuance date of this examination announcement. Information concerning other Civil Service Commission Rules involving announcements, applications and examination policies, including applicant appeal rights, can be found on the Civil Service Commission website at http://sfgov.org/civilservice/rules.  

Additional information regarding Employment with the City and County of San Francisco: 

• Information about the Hiring Process 
• Conviction History 
• Employee Benefits Overview 
• Equal Employment Opportunity 
• Disaster Service Workers
• Reasonable Accommodation
• Right to Work
• Copies of Application Documents
• Diversity Statement
• Veterans Preference
• Seniority Credit in Promotional Exams 

If you have any questions regarding this recruitment or application process, please contact the analyst, Hanz Pagao (she/her/hers) at [email protected] or 628-271-6839. 

We may use text messaging to communicate with you on the phone number provided in your application. The first message will ask you to opt in to text messaging.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.