Job Description

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:

1. 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 arrange for billing of the appropriate agency or health care plan.
2. Admits and registers patients for clinic and hospital services; initiates referrals for incoming skilled or long term care patients.
3. Coordinates transfers of patients between medical facilities; informs patients of procedures and necessary reports.
4. 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.
5. Prepares records related to patient eligibility information and financial assistance received; updates records; submits required reports.
6. Investigates statements and information received from applicant through the use of telephone or written verifications.
7. Investigates and resolves patient questions and concerns regarding clinic and hospital bills.
8. Reviews cases with supervisor in assessing the quality of the payment source determination process and procedure.
9.  Composes and prepares correspondence to patients, references, and State agencies; gathers statistical data and prepares reports as required.
10. Answers questions and provides information to patients and the general public regarding assigned program area.

2903 HOSPITAL ELIGIBILITY WORKER PERFORMS RELATED DUTIES AS REQUIRED. 

SHIFT(S): Varied depending on position location. Days, evenings, nights, overnights, weekends, and/or holiday shifts may be required. The hospitals operate on a 24-hour, 7 day per week basis and some Department of Public Health centers/clinics are open evenings, nights, weekends, and/or holidays. Rotation between functions and/or departments may be required.

Qualifications

Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.

MINIMUM QUALIFICATIONS (REQUIRED):

1. 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 financial or personal histories of clients; and
• assisting clients with the completion of forms or correspondence;

                OR

2. One (1) year of experience determining eligibility for health and/or social services programs, loans, financial assistance, unemployment or veterans benefits

                OR

3. Sixty (60) semester units or ninety (90) quarter units from an accredited college or university. (Please specify in your application how many units you have completed and/or if you have completed your degree)

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. (Please specify in your application how many units you have completed and/or if you have completed your degree)

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.

Please be clear in your application exactly how you meet the minimum qualifications listed above. Only the information entered in your application will be considered when determining whether you meet minimum qualifications. RESUMES WILL NOT BE ACCEPTED IN LIEU OF A COMPLETED CITY AND COUNTY OF SAN FRANCISCO APPLICATION. Applications that do not appear to meet the minimum qualifications will not move forward in the recruitment process. Please upload certificates, transcripts, employment verifications, performance appraisals, etc. that you feel will help demonstrate that you meet the minimum qualifications.

One year full-time 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 full-time employment.

VERIFICATION: Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Failure to provide the required verification when requested may result in rejection of application and/or appointment in this class. 

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.

SELECTION PROCEDURES

MINIMUM QUALIFICATION SUPPLEMENTAL QUESTIONNAIRE (WEIGHT: QUALIFYING): Candidates are required to complete a Supplemental Questionnaire as part of the online employment application. This Minimum Qualification Supplemental Questionnaire is designed to obtain specific information regarding an applicant's experience in relation to the Minimum Qualifications for this position. Applicants must also complete the official application. It is essential that applicants provide complete information in identifying their education, experience and training. The Minimum Qualification Supplemental Questionnaire will be used to evaluate if the applicant possesses the required minimum qualifications.

WRITTEN EXAMINATION (WEIGHT 100%): Candidates who meet the minimum qualifications will be invited to take a written multiple choice test designed to measure knowledge, skills, and/or abilities in job related areas which may include but not be limited to the following: Knowledge of: Basic interviewing and investigative skills and techniques; principles and practices of caseload management; Federal, State, local laws, rules, regulations, policies, and procedures regarding assigned program area; services offered by related agencies; departmental programs, policies, procedures and terminology; office procedures, methods and computer equipment; basic mathematics. Ability to: Interview applicants for public assistance and obtain appropriate information, often in different languages, or dialects of English; accurately gather, record and evaluate data necessary for the determination of eligibility; interpret and apply Federal, State and local policies, procedures, laws and regulations; maintain accurate records and meet program deadlines; operate a computer terminal and standard office machines; make accurate mathematical computations; type and enter data at a speed necessary for successful job performance; effectively communicate with and elicit information from patients in difficult situations; communicate clearly and concisely, both orally and in writing; establish and maintain cooperative working relationships with those contacted in the course of work.

A passing score must be achieved on the written multiple-choice examination in order to continue in the selection process. Candidates will be placed on the eligible list/score report in rank order according to their written examination score.

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

DATE(S) OF EXAMINATION: Those applicants meeting the Minimum Qualifications will be notified of the exact date, time and place to report to the examination.

Additional Information

ELIGIBLE LIST/SCORE REPORT: A confidential eligible list of applicant names that have passed the civil service examination process will be created, and used for certification purposes only. An examination score report will be established, so applicants can view the ranks, final scores and number of eligible candidates. Applicant information, including names of applicants on the eligible list, shall not be made public unless required by law. However, an eligible list shall be made available for public inspection, upon request, once the eligible list is exhausted or expired and referrals resolved. The eligible list/score report resulting from this civil service examination process is subject to change after adoption (e.g., as a result of appeals), as directed by the Human Resources Director or the Civil Service Commission.

LANGUAGE PROFICIENCY EXAM: For positions requiring bilingual fluency, candidates deemed qualified who meet the special language condition, must pass a department approved language proficiency exam prior to appointment. Only those eligible candidates who pass the bilingual proficiency test will be considered for the bilingual position. Applicants must indicate on the application form the language(s) in which they claim proficiency.

TERMS OF ANNOUNCEMENT: 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 will be posted at the top of the job ad.] 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.

STATEMENT ON EQUITY, DIVERSITY, AND INCLUSION: At the City and County of San Francisco, we share a commitment to a diverse, inclusive and equitable community. Each member of our organization is responsible and accountable for what they say and do to make San Francisco an inclusive and equitable place to live and work by employing fair and just practices to and for all.

ELECTRONIC HEALTH RECORD (EHR): The Department of Public Health (DPH) is implementing a unified Electronic Health Record (EHR) system and DPH employees must demonstrate competency in the use of the system that is appropriate for their classification as a condition of employment.  

PERSONAL PROTECTIVE EQUIPMENT (PPE): Some positions in the Department of Public Health will require the use of personal protective equipment (PPE), including but not limited to gloves, gowns, eye and face protection, and face-fitting respirators. The requirement for the use of PPE may come on short or no notice. Facial hair or any condition that interferes with a face-fitting respirator’s seal (i.e., weakens the seal between the respirator and the wearer’s bare skin) is not permitted when face-fitting respirators are worn, including during initial or periodic respirator fit-testing. Employees who choose not to shave and do not have either American Disabilities Act (ADA) or Equal Employment Opportunity (EEO) Accommodations do not have the right to alternate work assignments or the option of using a loose-fitting Powered Air Purifying Respirator (PAPR) in place of a Face Fitting Respirator.  

MEDICAL EXAMINATION: Prior to appointment, at the Department’s expense, applicants may be required to take a tuberculosis (TB) screening test, medical examination, and/or drug test. Medical Examination Information.

NOTE ON ICARE: Willingness to uphold/abide by ZSFG’s ICARE (I-Introduce, C-Connect, A-Ask, R-Respond, E-Exit) philosophy for employee and patient interactions.

DHR PUBLIC ACCESS: In line with the Official Public Health Order to slow the spread of COVID-19, “shelter-in-place” has been issued for all San Francisco residents that is expected to be in effect until further notice. As a result, Department of Human Resources (DHR)’s office (located at 1 South Van Ness Avenue, 4th Floor, San Francisco, CA 94103) is currently closed to the general public. If you have any questions, please feel free to email the Exam Analyst listed at this job ad.

A COVID-19 VACCINE BOOSTER IS REQUIRED FOR ALL SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH EMPLOYEES AS A CONDITION OF EMPLOYMENT EFFECTIVE MARCH 1, 2022.

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 Worker
• ADA Accommodation
• Veterans Preference
• Right to Work
• Copies of Application Documents
• Diversity Statement

All your information will be kept confidential according to EEO guidelines.

RECRUITMENT ANALYST INFORMATION: If you have any questions regarding this recruitment or application process, please contact Hanz Pagao at hanz.pagao@sfdph.org. Please respond to the application confirmation email if you already applied.

CONDITION OF EMPLOYMENT:  All City and County of San Francisco employees are required to be vaccinated against COVID-19 as a condition of employment.  For details on how it is applicable to your employment, please click here.

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.