Hospital Eligibility Worker Supervisor (2909) - DPH (H00156)

Under direction the Hospital Eligibility Worker Supervisor supervises assigns reviews and participates in the work of a unit responsible for a variety of hospital registration admitting and discharge functions with the objective of determining eligibility of patients for assistance under the terms of various public and private health care and financial assistance programs including MediCal and Medicare to maximize hospital reimbursement and facilitate patient care; and performs a variety of technical tasks relative to assigned area of responsibility.

ESSENTIAL DUTIES include:

1. Plans prioritizes assigns supervises and reviews 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 MediCal Medicare and other thirdparty payers.
2. Participates in the selection of unit staff; provides or coordinates staff training; works with employees to correct deficiencies; implements discipline procedures as required.
3. Recommends and assists in the implementation of goals and objectives; establishes schedules and methods for providing services; implements policies and procedures.
4. Evaluates operations and activities of assigned responsibilities; recommends improvements and modifications; prepares statistical summaries and reports on staff operations and activities.
5. Assists in the preparation and monitoring of the budget.
6. Answers questions and provides information to the public; investigates complaints and recommends corrective action as necessary to resolve complaints.
7. Reviews and evaluates staff work in determining financial eligibility for a variety of payment sources; verifies eligibility and financial assistance levels according to established policies and procedures; reviews completed cases with respect to eligibility factors and billing recommendations.
8. Maintains ongoing effective communication with various clinical staff including radiology staff nursing staff and physicians.
9. Reviews and interprets administrative letters memos and changes in program regulations; evaluates the impact of changes on internal procedures and hospital reimbursement for patient care; updates staff on changes in regulations and policy or procedures; maintains providers eligibility and procedures manual regulations and policy or procedures; maintains providers eligibility and procedures manual.
10. Determines eligibility recommends and explains thirdparty payment source programs qualification standards policy and procedure to patients; assists patients in completion of applications and forms when necessary; reviews and evaluates MediCal applications for completeness and accuracy; when necessary prepares the patient budget to determine eligibility.
11. Prepares records related to patient eligibility information and payment source received; updates records; submits required reports.
12. Investigates and verifies statements and information received from patients and families.
13. Acts as liaison with public and private medical care plans outside institutions and community organizations.
14. Oversees coordination of transfers of patients between various hospitals or medical facilities; ensures patients are informed of transfer procedures.
15. Oversees assignment of beds for patients being admitted; monitors bed availability; maintains a safe and clean work environment for employees.
16. May oversee workers assigned to a longterm care facility; supervises the regulating of patient finances facilities of burial arrangements and disposition of estate.
17. Oversees the maintenance and operation of computer and manually operated data equipment; monitors the adequacy of office supplies and forms; orders supplies and forms as required; prepares biweekly master payroll roster.

The Hospital Eligibility Worker Supervisor performs related duties as required.

Shift(s): Variable depending on position location. Days evenings nights weekends and/or holiday shifts may be required. Hospitals are open twentyfour (24) hours seven (7) days per week

Qualifications :

1. EXPERIENCE: Two (2) years of verifiable work experience in a hospital determining the eligibility for MediCal MediCare 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.
2. LICENSE AND CERTIFICATION: Must obtain Certified Enrollment Counselor Certification for Covered California and pass federal background check within three (3) months of hire.

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

Oneyear fulltime employment is equivalent to 2000 hours (2000 hours of qualifying work experience is based on a 40hour work week).

Condition of Employment: Must obtain Certified Enrollment Counselor Certification for Covered California and pass federal background check within 3 months of hire. Possession of a Certified Enrollment Counselor Certification for Covered California is required as a provision to employment for ALL positions. Eligibles who do not possess such a certification may participate in this examination process and be appointed to a position(s) but will be required to obtain the certificate within three (3) months of the hire date and maintain validity throughout the length of employment. A photocopy of the valid certification must be provided to the appropriate supervisor of the appointment within the allotted time frame. Valid certification must be kept current throughout the length of employment. Failure to demonstrate/show proof of possession of a valid certification within three (3) months of the hire date and throughout the length of employment may result in dismissal and/or termination of employment.

Special Condition Bilingual Proficiency: Some positions may require bilingual fluency in a variety of languages depending upon the departments 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. 

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. 

Our email communications may come from more than one department so please make sure your email is set to accept messages from all of us atthis must ensure that email from CCSF is not blocked on their computer by a spam filter. 

Applicants may be contacted by email about this recruitment. Please consider using a personal email address that you check regularly rather than a work or school account.

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  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 CAby 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  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
• Seniority Credit in Promotional Exams

If you have any questions regarding this recruitment or application process please contact the analyst Hanz Pagao at  or. 

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.