2908-Senior Hospital Eligibility Worker

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

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. The essential functions include:

• 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;
• Counsels patients about eligibility, billing policies, reimbursement programs, qualification standards, procedures, and payment options;
• Investigates payor requirements by obtaining benefits information, notifies insurance plans of patients' treatment needs;
• Assists patients and their representatives to apply for Medi-Cal, California Children Services, and other Federal, State, and County reimbursement programs;
• Assists in registering patients into the hospital;
• Communicates accurate financial reimbursement information and eligibility verification to healthcare professionals to aid in treatment planning;
• 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;
• Prepares, updates, and maintains records related to patient eligibility information and health care payment received;
• Maintains resource materials regarding regulations and procedures, procedural memos, and training material;
• Prepares patient budget to determine eligibility for coverage of medical care;
• Regulates patient finances to maintain patient eligibility and entitlement to various benefits.

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.

How to qualify

• 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.
• License and Certification: Must obtain Certified Enrollment Counselor Certification for Covered California and pass federal background check within 3 months of hire.

Special Conditions: Some positions may require bilingual fluency in a variety of languages depending upon the department's bilingual needs.

Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications.

What else should I know?

Selection Procedures: Candidates deemed qualified must complete all subsequent steps to advance in this selection process.

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.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply.

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