PATIENT FINANCIAL SERVICES WORKER

Position/Program Information

EXAM NUMBER:

PH9193E

TYPE OF RECRUITMENT:
OPEN COMPETITIVE JOB OPPORTUNITY

FILING DATE:
Friday, June 21, 2024 at 8:30 a.m. , Pacific Time (PT)

This examination will remain open until the needs of the service are met and is subject to closure without prior notice.

DEFINITION:
Acquires data essential to the determination of patients' eligibility for federal, State, County, or other healthcare programs; andassists patients in preparing/completing applications for healthcare programs to reimburse the County for healthcare services.

CLASSIFICATION STANDARDS:
Positions allocable to this class typically report to a Supervising Patient Financial Services Worker and have primary responsibility for interviewing patients or their relatives and/or representatives for the purpose of determining patients' eligibility for Medi-Cal and a variety of other healthcare programs,including the actual preparation/completion of applications for various governmental healthcareprograms. Positions in this class assist patients in identifying any personal financial resources they may have which will enable themto pay for healthcare services and/or to develop mutually acceptable payment plans.

Essential Job Functions

• Conduct telephone interviews to determine residential/financial eligibility for potential California Children's Services (CCS) clients who have been identified by the medical staff as not having Medi-Cal or who have been identified as having other health care coverage,
• Analyze data essential to the determination of the applicant's eligibility for a variety of Federal, State and county medical assistance programs, including Medi-Cal and Medi-Cal expansion to Optional Targeted Low Income Children's Program (OTLICP). Inform the applicant of their requirement to apply for other medical assistance programs and provide resources/referrals
• Contact commercial/private health insurance companies to verify benefits coverage
• Approve or deny cases in the CMS Net statewide system and when necessary, issue Notice of Action (NOA) letters on cases that are determined financially/residentially ineligible under the direction of the Administrative Liaison and Program Administrator
• Answer financial eligibility phone lines to ensure prompt and efficient service to callers and adhere to customer service standards set forth by the unit
• Interpret eligibility from the Medi-Cal Eligibility Data System (MEDS) then enter/update information on the CMS Net data system.
• Conduct daily follow-up on newborn cases approved under the mother's Medi cal, Gateway Medi-Cal, and Healthy Families with an annual income over forty thousand, as required by the State which have been identified as approved by the Nurse Case Manager (NCM).
• Coordinate the resolution of any discrepancies pertinent to the determination program eligibility with the case management staff.
• Function as a liaison to DPSS to resolve issues regarding a client's Medi-Cal eligibility.
• Function as liaison for the CCS NCM staff and program vendors to facilitate financial eligibility issues,
• Assist CCS physicians in the process of evaluating cases for clients with an Annual Gross Income (AGI) exceeding $40,000, settlements and commercial HMO (Health Maintenance Organization) insurance cases,
• Interpret provisions and requirements of the various governmental medical assistance programs for families and CCS medical staff.
• Follow-up on financial pending cases within the timeframe indicated by the unit
• Submit newborn referral forms to the Department of Public Social Services (DPSS) in order to add newborns to mother's Medi-Cal case.
• Provide potential guardians with information and necessary documents to apply for legal guardianship.
• Evaluate a variety of legal documents such as divorce decrees, private/governmental settlements, adoptions papers, and commercial insurance policies.
• Coordinate with the Department of Health Services (OHS) Third Party Liability Branch to add, delete or correct commercial health insurance information on California statewide MEDS.

Requirements

SELECTION REQUIREMENTS:

OPTION I: Completion of 60 semester units or 90 quarter units* from an accredited college or university - AND - one (1) year of experience interviewing the public in connection with applications for financial assistance, credit, insurance, medical or hospital services, social security or workers' compensation.

OPTION II: Two (2) years of experience as a Patient Resources Worker*** or higher interviewing patients or their relatives and/or representatives to determine patients' financial resources to pay for healthcare services.

OPTION III: One (1) year of experience in the supervision of Patient Resources Workers****.

LICENSE:
A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions.

PHYSICAL CLASS:
Physical Class II - Light: This class includes administrative and clerical positions requiring light physical effort that may include occasional light lifting to a 10 pound limit and some bending, stooping, or squatting. Considerable ambulation may be involved.

SPECIAL REQUIREMENTS INFORMATION:
You must POSSESS and CLEARLY EXPRESS detailed years of experience performing relevant duties, related to the requirements within your online job application under the "Experience" area .

No out-of-class experience will be accepted.

No withholds allowed. Requirements must be met at the time of application submission.

* In order to receive credit for any type of college/university course work, or any type of college degree, you must include a legible copy of the Official Transcript(s)** from the accredited institution which shows c ompletion of 60 semester units or 90 quarter units and the date the degree was awarded if applicable, with Registrar's signature and/or school seal with your application online at the time of filing or within fifteen (15) calendar days from application submissio n to HRExams@ph.lacounty.gov .

• Foreign degrees must be evaluated for equivalency to United States accredited institutions standards by an academic credential evaluation agency recognized by The National Association of Credential Evaluation Services or the Association of International Credential Evaluators, Inc. (AICE). See Employment Information under Accreditation Information.

**Official Transcript is defined as a transcript that bears the college seal and states "official and/or copy" issued by the school's Registrar Office. A printout of the transcript from the school's website is NOT considered official and, therefore, will NOT be accepted and may result in your application being incomplete and be rejected.

NOTE: If you are unable to attach the required documents with your application online, you must e-mail them to HRExams@ph.lacounty.gov within fifteen (15) calendar days from application submission. In the "Subject" of the e-mail please type the Exam Number and Exam Title.

*** To qualify applicants must have County status as a Patient Resources Worker or higher, as evidenced by holding or having held such payroll title in the service of Los Angeles County for the required amount of time to qualify.

****Patient Resources Worker is defines as identifies patients' financial resources to pay for medical and/or mental health care and services; and assists patients in making assignments for medical benefits, and completes standardized billing forms based upon data acquired.

DESIRABLE QUALIFICATIONS:
Credit will be given to applicants who possess the following desirable qualifications:

• Additional experience beyond the Selection Requirements.
• Experience using the State’s Medi-Cal Eligibility Determination System (MEDS), including interpretation of aid codes.

Additional Information

EXAMINATION CONTENT:
Once we have determined that you meet the education and experience requirements described above, our examination process will consist of an evaluation of education and experience based on application information, desirable qualifications, and supplemental questionnaire information at the time of filing weighted 100%.

Applicants must meet the Requirements and achieve a passing score of 70% or higher on each part of the examination in order to be added on the Eligible Register (hiring list).

Passing this examination and being added to the Eligible Register does not guarantee an offer of employment.

ELIGIBILITY INFORMATION:
The names of candidates will be added to the Eligible Register in the order of their score group for a period of twelve (12) months following the date of eligibility.

NO PERSON MAY COMPETE IN THIS EXAMINATION MORE THAN ONCE EVERY TWELVE (12) MONTHS .

Complete applications will be processed on an as-received basis and promulgated to the Eligible Register accordingly.

VACANCY INFORMATION:
The Eligible Register resulting from this examination will be used to fill vacancies in the Department of Public Health as they occur.

AVAILABLE SHIFT: Any, including evenings, nights, weekends and holidays.

SPECIAL INFORMATION

APPLICATION AND FILING INFORMATION:
Applications must be filed ONLINE ONLY . Applications submitted by U.S. mail, fax, or in person will NOT be accepted.

Apply online by clicking on the green "Apply" button located on this posting. You can also track the status of your application using this website.

Plan to submit your online application before the 5:00 p.m. (PT) deadline on the last day of filing as you may be required to verify your email address. This only needs to be done once per email address, and if you already have a job seeker account on the County of Los Angeles Job Opportunities Website, you can verify at any time by logging in and following the prompts. This is to enhance the security of your online application and to ensure you do not enter an incorrect email address.
Any required documents and/or additional information, if any, must be received with your application at the time of filing online or within fifteen (15) calendar days from application submission to HRExams@ph.lacounty.gov. In the "Subject" of the e-mail please type the Exam Number and Exam Title. Failure to provide complete, accurate information will impact the assessment of your qualifications and the acceptance of your application into the examination process.

The acceptance of your application depends on whether you have clearly shown that you meet the REQUIREMENTS . Fill out the application and Supplemental Questionnaire accurately and completely to receive full credit for any relevant education and/or job experience you include. In the space provided on the application for education, include names and addresses of schools attended, dates attended, degree(s) received, and degree major. For each job held, give the name and address of your employer, your job/position title, start and end dates, the number of hours worked per week, and detailed description of work and duties performed. If the application and/or Supplemental Questionnaire is/are incomplete, the application will be REJECTED .

IMPORTANT NOTES:

• Please note that ALL information supplied by applicants and included in the application materials is subject to VERIFICATION at any point during the examination and hiring process, including after an appointment has been made.
• Applications may be rejected at any stage of the examination and selection process.
• FALSIFICATION of any information may result in DISQUALIFICATION or RESCISSION OF APPOINTMENT .
• Utilizing VERBIAGE from Class Specification(s) and/or Selection Requirements serving as your description of duties WILL NOT be sufficient to demonstrate that you meet the requirements. In doing so your application will be dispositioned as INCOMPLETE and will not be accepted.
• Comments such as "SEE RESUME" or "SEE APPLICATION" will not be considered a valid response; therefore, using such statements will also result in your application being rejected as INCOMPLETE .

COMPUTER AND INTERNET ACCESS AT PUBLIC LIBRARIES:

For candidates who may not have regular access to a computer or the internet, applications can be completed on computers at public libraries throughout Los Angeles County. Check the website for updated information at https://lacountylibrary.org .

SOCIAL SECURITY NUMBER:

Please include your Social Security Number for record control purposes. Federal law requires that all employed persons have a Social Security Number.

DO NOT SHARE USER ID AND PASSWORD:

All applicants must file their application online using their OWN user ID and password. Using a family member or friend's user ID and password may erase a candidate's original application record.

ANTI-RACISM, DIVERSITY, AND INCLUSION (ARDI):
The County of Los Angeles recognizes and affirms that all people are created equal and are entitled to all rights afforded by the Constitution of the United States. The Department of Human Resources is committed to promoting Anti-racism, Diversity, and Inclusion efforts to address the in equalities and disparities amongst race. We support the ARDI Strategic Plan and its goals by improving equality, diversity, and inclusion in recruitment, selection, and employment practices.

FAIR CHANCE EMPLOYER:

The County of Los Angeles is a Fair Chance employer. Except for a very limited number of positions, you will not be asked to provide information about a conviction history unless you receive a contingent offer of employment. The County will make an individualized assessment of whether your conviction history has a direct or adverse relationship with the specific duties of the job, and consider potential mitigating factors, including, but not limited to, evidence and extent of rehabilitation, recency of the offense(s), and age at the time of the offense(s). If asked to provide information about a conviction history, any convictions or court records which are exempted by a valid court order do not have to be disclosed.

EQUAL EMPLOYMENT OPPORTUNITY:

It is the policy of the County of Los Angeles to provide equal employment opportunity for all qualified persons, regardless of race, religion, sex, national origin, age, sexual orientation, or disability or any other characteristic protected by State or Federal law. All positions are open to qualified men and women pursuant to the Americans with Disabilities Act of 1990 and the California Fair Employment and Housing Act. The County will follow all of its obligations under State and Federal laws regarding the provision of reasonable accommodations to applicants.



Department Contact Name: Exam Analyst

Department Contact Phone: (323) 659-6546

Department Contact E-mail: HRExams@ph.lacounty.gov

Exam Number: PH9193E



California Relay Services Phone: (800) 735-2922

ADA Coordinator Phone: (323) 659-6546

Teletype Phone: (800) 899-4099

Alternate Teletype Phone: (800) 897-0077

For detailed information, please click here

Closing Date/Time: Continuous

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