Job Description

Under supervision, the 1635 Health Care Billing Clerk I reviews and evaluates medical claims to third-party payors, Medicare, and Medi-Cal for services provided to patients by the Department of Public Health.

The 1635 Health Care Billing Clerk I performs the following essential job functions:

• Reviews, evaluates, and processes bills for services rendered to patients in order to obtain reimbursement from various insurance carriers and government programs;
• Evaluates billing documents and claims data for accuracy and completeness, obtaining missing or correct data when necessary from sources such as the patient's medical record, discharge summary, and Admissions forms;
• Prepares the claims forms by completing the information required and categorizing the billing charges by grouping them according to types of medical services provided;
• Reviews electronic and lockbox payments and posts to corresponding accounts;
• Researches questions and concerns, and provides assistance to patients, physicians, insurance and legal representatives, and others regarding claims reimbursement and coverage;
• Queries electronic databases in order to verify patient's medical records number to ensure that the proper medical chart is requested.

The 1635 Health Care Billing Clerk I also performs other related duties as required.

Qualifications

Minimum Qualifications - Required

** EXPERIENCE:** **** Six (6) months of experience billing, claims processing and/or collecting healthcare service reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third-party payors, and individual payors in a hospital, healthcare agency, or healthcare billing organization.

Substitution : Completion of 15 semester units or 22 quarter units of medical billing related coursework from an accredited college or university may substitute for six (6) months of qualifying experience.

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.

Additional Information

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

Assessment Component
Candidates that meet the minimum qualifications will be invited to participate in written multiple-choice exam that is designed to measure the knowledge, skills, and abilities in job related areas which may include but not be limited to:

• Knowledge of medical claim data collection, billing, and processing for reimbursement from Medicare, Medi-Cal, commercial, and third-party payers
• Knowledge of basic medical terminology
• Knowledge modern office practices and procedures
• Knowledge of payment posting procedures
• Ability to perform detailed clerical work in a methodical and thorough manner with accuracy
• Ability to read and analyze a medical chart. Ability to read and understand information and ideas presented in writing
• Interpersonal relations ability
• Ability to perform mathematical calculations accurately and effectively
• Ability to use a personal computer to enter and update data, create documents, and use system applications, email, spreadsheets, and word-processing software

Written Examination (Weight: 100%): Candidates must achieve a passing score on the written multiple-choice exam 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.

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

NOTE: Qualified applicants will receive an email notifying them of the examination's exact time and location. If you also apply and meet the minimum qualifications for the 1636 Health Care Billing Clerk II recruitment, you will only be scheduled for the examination once. Your score will then be applied to both recruitments.

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

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 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

If you have any questions regarding this recruitment or application process, please contact the analyst, Katrina Navarro atkatrina.navarro@sfdph.org or ( 628) 271-6717.

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.