Career Opportunity

2909-Hospital Eligibility Worker Supervisor

Recruitment: RTF0128330-01016438

Published: April 21, 2023

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About:

• Application Opening - January 31, 2023
• Application Deadline – February 14, 2023 opened untill filled 
• Salary: $49.08-$59.68 Hourly
• Shift:  Saturday/Sunday 1045 AM – 715 PM; Monday/Thursday/Friday 1245 PM – 915 PM

This role is a supervisor in a 7 Day Call Center operation. May require rotating weekend shifts and shift ranges from 600 AM – 915 PM. Regular days off rotating depending on the needs of the operation, including COVID-19 response and other DSW activations.

• Location: Primary Care - Centralized Call Center - Multiple Locations Laguna Honda Hospital - 375 Laguna Honda Boulevard, San Francisco, CA 

• All 2909s in Primary Care may be asked to provide coverage for vacancies, vacations and leaves at other Primary Care sites. Recruitment Id: RTF0128330-01016438Appointment Type: Temporary Provisional

Temporary provisional (TPV) appointee must participat­­­e and be successful in a Civil Service Examination process for this classification and be selected through an open competitive process in order to be considered for a permanent appointment. Provisional appointments may not exceed three (3) years.

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 two main Divisions - the San Francisco Health Network and Population Health.

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.

DPH statement of Diversity, Equity and Inclusion 

The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the diversity of its workforce. All employees are required to participate in the Department of Public Health's work to advance equity, inclusion, and diversity through:  

• Commitment to providing exceptional care and services to all residents of the City and County of San Francisco service population, with heightened awareness of responsiveness to racially, ethnically, and culturally diverse members of the service population and the DPH workforce.  
• Desire and commitment to lead and participate in anti-racism, racial justice, and equity work that improves quality of patient care and employee experiences; along with the commitment and fortitude to drive change in these areas.  
• Desire to work with, relate to, serve, and support a diverse service population and workforce.  
• Commitment to health equity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status 

Role description

Under general supervision of the Call Center Director, the 2909 Hospital Eligibility Worker Supervisor performs the following essential duties:

• Directs, assigns, and reviews the work of Hospital Eligibility Workers (2903s) engaged in the determination of patients’ financial ability to pay for medical treatment under the requirements of various public and private medical programs.
• Plan, prioritize, assign, supervise and review the work of a unit responsible for providing the review and determination of eligibility of patients for medical treatment under the terms of various public and private medical and financial assistance programs including Medi-Cal, Medicare and other third-party payers.
• Participate in the selection of unit staff; provide or coordinate staff training; work with employees to correct deficiencies; implement discipline procedures as required.
• Recommend and assist in the implementation of goals and objectives; establish schedules and methods for providing services; implement policies and procedures.
• Evaluate operations and activities of assigned responsibilities; recommend improvements and modifications; prepare statistical summaries and reports on staff, operations and activities.
• Answer questions and provide information to the public; investigate complaints and recommend corrective action as necessary to resolve complaints.
• Review and evaluate staff work in determining financial eligibility for a variety of payment sources; verify eligibility and financial assistance levels according to established policies and procedures; review completed cases with respect to eligibility factors and billing recommendations.
• Maintain on-going effective communication with various clinical staff including radiology staff, nursing staff and physicians.
• Review and interpret administrative letters, memos and changes in program regulations; evaluate impact of changes on internal procedures and hospital reimbursement for patient care; update staff on changes in regulations and policy or procedures; maintain providers’ eligibility and procedures manual.
• Determine eligibility, recommend and explain third party payment source programs, qualification standards, policy and procedure to patients; assist patients in completion of applications and forms when necessary; review and evaluate Medi-Cal applications for completeness and accuracy; when necessary, prepare patient budget to determine eligibility.
• Prepare records related to patient eligibility information and payment source received; update records; submit required reports.
• Investigate and verify statements and information received from patient and families.
• Act as liaison with public and private medical care plans, outside institutions and community organizations.
• Oversee the maintenance and operation of computer and manually operated data equipment; monitor adequacy of office supplies and forms; order supplies and forms as required; prepare biweekly master payroll roster.
• Accurately gather, record and evaluate data necessary for the determination of eligibility; evaluate data and provide recommendations on patient eligibility.
• Interpret and apply Federal, State, local, hospital and Departmental policies, procedures, laws, and regulations.
• Perform related duties as required.

How to qualify

• EXPERIENCE: Two (2) years of verifiable work experience in a hospital determining the eligibility for Medi-Cal, Medi-Care or other sources of hospital reimbursement. This work must have been performed within the last five (5) years and must be equivalent to the work performed by a class 2908 Hospital Eligibility Worker.
• LICENSE AND CERTIFICATION: Must obtain Certified Enrollment Counselor Certification for Covered California and pass federal background check within 3 months of hire.

Special Condition: Bilingual Proficiency Cantonese

Language Proficiency Exam:
Candidates deemed qualified who meet the special condition target language must pass a departmentally approved language proficiency exam prior to appointment.  Only those eligible candidates who pass the bilingual proficiency test will be considered for the bilingual position.

Desired Qualifications

• Knowledge of telephone and computer systems and methods and techniques needed to operate equipment utilized in a high-volume inbound Call Center.
• Operate a computer terminal and Multi-Line Telecommunication System.
• Respect the right of privacy and maintain confidentiality of callers; and to be attentive to, and accurately record details of calls and referrals; and prepare written documents in a clear, concise, accurate and understandable manner.

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). Any overtime hours that you work above 40 hours per week are not included in the calculation to determine fulltime employment.

Verification of Experience:
Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process.

Verification of Education: If education verification is required, information on how to verify education requirements, including verifying foreign education credits or degree equivalency, can be found at http://sfdhr.org/how-verify-education-requirements

Note: Falsifying one’s education, training, or work experience or attempted deception on the application may result in disqualification for this and future job opportunities with the City and County of San Francisco.

All work experience, education, training and other information substantiating how you meet the minimum qualifications must be included on your application by the filing deadline. Information submitted after the filing deadline will not be considered in determining whether you meet the minimum qualifications.

Applications completed improperly may be cause for ineligibility, disqualification or may lead to lower scores.

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

The selection procedure will include evaluation of the application packet in relation to minimum requirements. Depending on the number of applicants, the Department may establish and implement additional screening mechanisms to comparatively evaluate qualifications of candidates.   

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

What else should I know?

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 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. 

DPH Health Critical Requirements and Information: Please review the following policies regarding DPH employment requirements that safeguard yourself and others. 

• COVID-19 Policies 
• Personal Protective Equipment (PPE) 
• Medical Examination Prior to Hiring 
• Electronic Health Record (EHR) 
• Licensure/Certification/Registration 

• Note on ICARE 

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  

If you have any questions regarding this recruitment or application process, please contact the exam analyst, Ileana Enriquez at Ileana.Enriquez@sfdph.org or (628) 271-6708.

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.” 

CONDITION OF EMPLOYMENT:  All City and County of San Francisco employees are required to be fully vaccinated against COVID-19 as a condition of employment. Someone is fully vaccinated when 14 days have passed since they received the final dose of a two-shot vaccine or a dose of a one-shot vaccine. Any new hire must present proof of full vaccination status to be appointed. Any new hire who will be routinely assigned or occasionally enter High-Risk Settings, must provide proof of having received a COVID-19 booster vaccine by March 1, 2022, or once eligible.

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.