PATIENT FINANCIAL SERVICES WORKER

Updated: June 20

Los Angeles County

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Job Abstract

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... more details

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; and assists 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 healthcare programs. Positions in this class assist patients in identifying any personal financial resources they may have which will enable them to 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 completion 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 submission 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

COUNTY OF LOS ANGELES

Employment Information

Any language contained in the job posting supersedes any language contained below.

Your Responsibilities:

1. Completing Your Application:

a. Before submission of the application, it is your responsibility to ensure that all information provided is correct and complete on the application. Incomplete applications cannot be accepted.

b. List each payroll title separately for each job. Do not group your experience. Specify the beginning and ending dates for each job. If you are a Los Angeles County employee and have held multiple positions, do NOT list all of your time with the County under your present payroll title.

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

d. To receive credit, include required documents (e.g., copy of your diploma, transcript, certificate, or license) as directed on the job posting. International degrees in a foreign language must be translated to English and evaluated for equivalency to U.S. standards. Refer to the job posting for specific deadlines for supporting documentation.

2. Requirements on Job Posting:

a. Your application will only be accepted if it clearly shows you meet the requirements. The information you give will determine your eligibility and is subject to verification at any time.

b. You must be at least 16 years of age at the time of appointment unless other age limits are stated on the job posting. The Federal Age Discrimination in Employment Act (ADEA) of 1967, as amended, prohibits discrimination on the basis of age for any individual age 40 or older.

c. Experience is evaluated on the basis of a verifiable 40- hour week, unless specified otherwise. Prorated part-time experience may be acceptable.

3. Application Deadline: All job applications must be completed and submitted before the closing time on the last day of the filing period as indicated on the job posting unless other instructions are provided. Job postings with an open continuous filing period are subject to closure without prior notice. It is to your advantage to file your application early and not wait until the last allowable date and time as you will not be able to apply once the filing period has closed.

4. Change of Name or Address: To change personal information such as your name or address, log into your profile on www.governmentjobs.com and make the necessary change. This can be done at any time.

5. Equal Employment Opportunity/Non-Discrimination Policy:

a. It is the policy of the County of Los Angeles to provide equal employment opportunity for all qualified persons, regardless of race, color, religion, sex, national origin, age, sexual orientation, disability, or any other characteristic protected by state or federal law. b. If you are an individual requesting reasonable accommodation(s) in the examination process, please contact the testing accommodation coordinator listed on the job posting. The provision of accommodation(s) may be subject to verification, consistent with state and federal law. All accommodation-related information will remain confidential.

Disclaimer: The County of Los Angeles is not responsible or in any way liable for any computer hardware or software malfunction that may affect the employment application or the application selection process.

You assume all responsibility and risk for the use of this system and the Internet generally. This system and the information provided on it are provided on an "as is" and "as available" basis without warranties of any kind, either express or implied. No advice or information given by the County of Los Angeles or its respective employees shall modify the foregoing or create any warranty.

The County of Los Angeles expressly disclaims any warranty that the information on this system or on the Internet generally will be uninterruptible or error free or that any information, software or other material accessible from the system is free of viruses or other harmful components. You shall have no recourse against the County of Los Angeles as the system provider for any alleged or actual infringement of any proprietary rights a user may have in anything posted or retrieved on our system.

The County of Los Angeles shall not be liable for any direct, indirect, punitive, incidental, special or consequential damages arising out of or in any way connected with the use of this system or with the delay or inability to use it (or any linked sites), or for any information obtained through this system, or otherwise arising out of the use of this system, the Internet generally or on any other basis.

NOTE: Your application is submitted using Secure Encryption to ensure the privacy of all information you transmit over the Internet.

By accepting the Use Disclaimer set forth herein, you agree to all of the above terms and further agree to use this Online Job Employment Application System only for the submission of bona fide employment applications to the County of Los Angeles. Any other use of this Online Job Employment Application System, including without limitation any copying, downloading, translating, decompiling, or reverse engineering of the system, data, or related software, shall be a violation of the Use Disclaimer.

Test Preparation: Study Guides and other resources are available to help candidates prepare for employment tests. An interactive system for taking practice tests may be accessed on the Department of Human Resources website at https://hr.lacounty.gov/. Additional resources may be listed on the job posting.

Veteran’s Credit: In all open competitive examinations, a veteran’s credit of 10 percent of the total credits specified for such examinations will be added to the final passing grade of an honorably discharged veteran who served in the Armed Forces of the United States under any of the following conditions: During a declared war; -or- During the period April 28, 1952 through July 1, 1955; -or- For more than 180 consecutive days, other than for training, any part of which occurred after January 31, 1955, and before October 15, 1976; -or- During the Gulf War from August 2, 1990 through January 2, 1992; -or- For more than 180 consecutive days, other than for training, any part of which occurred during the period beginning September 11, 2001, and ending on August 31, 2010 the last day of Operation Iraqi Freedom; -or- In a campaign or expedition for which a campaign medal or expeditionary medal has been authorized and awarded. Any Armed Forces Expeditionary medal or campaign badge, including El Salvador, Lebanon, Grenada, Panama, Southwest Asia, Somalia, and Haiti qualifies for credit.

A campaign medal holder or Gulf War veteran who originally enlisted after September 7, 1980 (or began active duty on or after October 14, 1982, and has not previously completed 24 months of continuous active duty) must have served continuously for 24 months or the full period called or ordered to active duty.

This also applies to the spouse of such person who, while engaged in such service was wounded, disabled or crippled and thereby permanently prevented from engaging in any remunerative occupation, and also to the widow or widower of any such person who died or was killed while in such service. A DD214, Certificate of Discharge or Separation from Active Duty, or other official documents issued by the branch of service are required as verification of eligibility for Veterans preference. Applicants must submit the documentation for each open competitive exam to qualify for veteran’s credit. More information available at: https://www.opm.gov/policy-data-oversight/veterans-services/vet-guide-for-hr-professionals/

Accreditation Information: Accredited institutions are those listed in the publications of regional, national or international accrediting agencies that are accepted by the Department of Human Resources. Publications such as American Universities and Colleges and International Handbook of Universities are acceptable references. Also acceptable, if appropriate, are degrees that have been evaluated and deemed to be equivalent to degrees from United States accredited institutions by an academic credential evaluation agency recognized by The National Association of Credential Evaluation Services or the Association of International Credential Evaluators, Inc. (AICE). More information is available at: http://file.lacounty.gov/SDSInter/dhr/070812_PPG123.pdf and http://file.lacounty.gov/SDSInter/dhr/205105_PPG_123_AC E_Resource_Guide.pdf

Background Check: The County of Los Angeles is a Fair Chance employer. Except as otherwise permissible under applicable laws, you will not be asked to provide information about a conviction history unless you receive a conditional 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 will also 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.

Career Planning: Resources to help current and prospective employees plan a career with Los Angeles County are available. To explore career paths to and from nearly all job titles, please visit our interactive Career PathFinder application at https://career-pathfinder.hr.lacounty.gov/#/.

Benefit Information: Depending on the position, the successful candidate will enroll in a contributory defined benefit pension plan if the candidate is a “new member” of the County’s defined benefit plan (LACERA) on or after January 1, 2013 (first employed by the County on or after December 1, 2012) – unless she or he established reciprocity with another public retirement system in which she or he was a member before January 1, 2013. It should be noted that County employees do not pay into Social Security, but do pay the Medical Hospital Insurance Tax portion of Social Security at a rate of 1.45%. The Los Angeles County Employees Retirement Association (LACERA) has reciprocal agreements with several public retirement systems in California.

Americans with Disabilities Act of 1990: All positions are open to qualified men and women. Pursuant to the Americans with Disabilities Act of 1990, persons with disabilities who believe they need reasonable accommodation, or help in order to apply for a position, may contact the ADA/Personnel Services for Disabled Persons Coordinator. Hearing impaired applicants with telephone teletype equipment may leave messages by calling the teletype phone number on the job posting. The County will attempt to meet reasonable accommodation requests whenever possible.

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, 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 comply with all of its obligations under State and Federal laws regarding the provision of reasonable accommodations to applicants.

Los Angeles County Child Support Compliance Program: In an effort to improve compliance with court ordered child, family and spousal support obligations, certain employment and identification information (i.e., name, address, Social Security number and date of hire) is regularly reported to the State Directory of New Hires which may assist in locating persons who owe these obligations. Family Code Section 17512 permits under certain circumstances for additional employment and identifying information to be requested. Applicants will not be disqualified from employment based on this information.

Social Security Act of 2004: Section 419 (c) of Public Law 108-203, the Social Security Protection Act of 2004, requires State and local government employers to disclose the effect of the Windfall Elimination Provision and the Government Pension Offset Provision to employees hired on or after January 1, 2005, in jobs not covered by Social Security. The County of Los Angeles does not participate in the Social Security System. All newly hired County of Los Angeles employees must sign a statement (Form SSA-1945) prior to the start of employment indicating that they are aware of a possible reduction in their future Social Security benefit entitlement. For more information on Social Security and about each provision, you may visit the website www.socialsecurity.gov, or call toll free 1-800-772- 1213. Persons who are deaf or hard of hearing may call the TTY number 1-800-325-0778 or contact a local Social Security office.

Employment Eligibility Information: Final appointment is contingent upon verification of U.S. citizenship or the right to work in the United States. Immigration law provides that all persons hired after November 6, 1986, are required to present original documents to the County, within three (3) business days of hiring, which show satisfactory proof of 1) identity and 2) U.S. employment eligibility.

The California Fair Employment and Housing Act (Part 2.8 commencing with Section 12900 of Division 3 of Title 2 of the Government Code) the Regulations of the Fair Employment and Housing Commission (California Code of Regulations, Title 2, Division 4, Sections 7285.0 through 8504) and other applicable laws prohibit employment discrimination based on an applicant's protected characteristics, including race, color, religion, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, sexual orientation, age, pregnancy, childbirth, and other characteristics.

COVID-19 VACCINATION: Some County workforce members may be required to be fully vaccinated against COVID-19. Successful candidates for those positions/classifications may be required to submit proof of vaccination against COVID-19 or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not present proof of vaccination until instructed to do so by the hiring department.

Updated February 2024

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