Exempt to Permanent - Hospital Eligibility Worker (2903) Citywide (E10161)

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 arranges 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 the 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 the 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 the assigned program area.

2903 Hospital Eligibility Worker performs related duties as assigned/required. 

Qualifications :

Current Category 16 17 or 18 Exempt Employee in Class 2903 who has worked at least 2080 hours in class 2903; AND

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 the 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. 

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 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.

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

One year of full-time employment is equivalent to 2000 hours of qualifying work experience (one year if performed full-time at 40 hours per week).

Special Requirements:

Special Qualifications including specialized knowledge abilities education experience or license may be established for individual positions.

Resumes will not be accepted in lieu of a completed City and County of San Francisco application. Applications completed improperly may be cause for ineligibility disqualification or may lead to a lower score.

Additional Information :

SELECTION PROCEDURES:

1. Job Application - Applicants must fully complete the job application. Information from resumes does not substitute for the information on the job application or preliminary questionnaire.
2. Preliminary Questionnaire  Training and Experience Assessment (100% Weight) - During the application process candidates will be prompted to complete a Preliminary Questionnaire as part of the online employment process. Please answer the Preliminary Questionnaire carefully and thoroughly.  It will serve as the Training and Experience Assessment for this recruitment and will be used to determine your eligibility for this recruitment as well as your score and rank on the eligible list. Qualified applicants will be ranked on the eligible list based on the length of their exempt City service (in Category 16 17 and/or 18) in the 2903 Hospital ELigibility Worker class along with any additional qualifying points (e.g. promotive status) as outlined in Civil Service Commission (CSC) rules. All work history will be verified using official City records which will serve as the final authority in determining qualifying service.

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

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. 

Certification
The certification rule for the eligible list resulting from this examination will be theRule 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  duration of the eligible list resulting from this examination process will be 6 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 online at .

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 at this link. Applicants 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 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  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 Hanz Pagao (she/her/hers) 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.