1636 Health Care Billing Clerk II

Recruitment #CBT-1636-903261

Introduction

1636 Health Care Billing Clerk II

This announcement has been extended to reflect a change in the selection procedure.

General Job Description:

Under general supervision, processes difficult and complex medical claims to Medicare, Medi-Cal, commercial and third-party payors for services provided to patients by the Department of Public Health.

Essential Duties:
The 1636 Health Care Billing Clerk II performs the following essential job functions:

  • Processes bills and claims for services rendered to patients in order to obtain reimbursement from Medicare, Medi-Cal, commercial, and third-party payors based upon current governmental billing rules and regulations;
  • Evaluates billing documents and claims data for accuracy, completeness and program compliance;
  • Prepares the initial claims and the follow-up claim if necessary by categorizing charges according to the types of medical services provided, completing medical information, verifying that all charges relate to the diagnosis and calculating the charges and benefits according to regulations;
  • Spends down Medi-Cal share of cost in order to certify monthly coverage to allow processing of claims;
  • Posts payments received from various payors, including Medicare, Medi-Cal, commercial, and third-party payors;
  • Sends Claims Inquiry Forms (CIFs), appeals, and tracers on unpaid accounts at predetermined intervals;
  • Researches questions and denials and provides assistance to patients, physicians, insurance and legal representatives, fiscal intermediaries and other regarding claims reimbursement and coverage;
  • Produces reports relevant to billing and claims activities using electronic databases.

The 1636 Health Care Billing Clerk II also performs other related duties as required.

 

Minimum Qualifications

Experience:
One (1) year of experience billing, claims processing and/or collecting healthcare services reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third-party payors, and individual payors in a hospital, healthcare agency, or healthcare organization.

Substitution:
Completion of 15 semester units or 22 quarter units of medical billing related coursework from an accredited college or university may substitute for six (6) months of qualifying experience.

How To Apply

Applications for City and County of San Francisco jobs are only accepted through an online process. Visit www.jobaps.com/sf to register an account (if you have not already done so) and begin the application process.

  • Select the desired job announcement
  • Select “Apply” and read and acknowledge the information
  • Select either “I am a New User” if you have not previously registered, or “I have Registered Previously”
  • Follow instructions on the screen

Computers are available for the public (from 8:00 a.m. to 5:00 p.m. Monday through Friday) to file online applications in the lobby of the Dept. of Human Resources at 1 South Van Ness Avenue, 4th Floor, San Francisco.

Applicants may be contacted by email about this announcement and, therefore, it is their responsibility to ensure that their registered email address is accurate and kept up-to-date. Also, applicants must ensure that email from CCSF is not blocked on their computer by a spam filter. To prevent blocking, applicants should set up their email to accept CCSF mail from the following addresses (@sfgov.org, @sfdpw.org, @sfport.com, @flysfo.com, @sfwater.org, @sfdph.org, @asianart.org, @sfmta.com, @sfpl.org, @dcyf.org, @first5sf.org, @famsf.org, @ccsf.edu).

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.

All work experience, education, training and other information substantiating how you meet the minimum qualifications must be included on your application by the filing deadline. Information submitted after the filing deadline will not be considered in determining whether you meet the minimum qualifications.

Applications completed improperly may be cause for ineligibility, disqualification or may lead to lower scores.

If you have any questions regarding this recruitment or application process, please contact the HR Analyst, Patrick Cheng, by telephone at 415-554-2919, or by email at Patrick.Cheng@sfdph.org.

Selection Procedures

Supplemental Questionnaire: (Weight: Qualifying):
Applicants will be prompted to complete a supplemental questionnaire as part of the online employment application. It is essential that applicants provide complete information in identifying their education, experience, training and licensure, consistent with the information provided on their application. The supplemental questionnaire will be used to evaluate whether applicants meet the minimum qualifications for this position. Applicants must also complete the official application. The information in the supplemental questionnaire will not be scored and is collected for informational purposes.

Written Core Examination (Weight: 100%):
Candidates who meet the minimum qualifications will be invited to participate in a written multiple-choice examination to determine their relative knowledge, skill and ability for the 1636 Health Care Billing Clerk II, which may include, but is not limited to:

- Knowledge of medical claim data collection, billing, and processing for reimbursement from Medicare, Medi-Cal, commercial, and third-party payers
- Knowledge of basic medical terminology
- Ability to use a personal computer to enter and update data, create documents and use system applications, e-mail, spreadsheets, and word-processing software

- Knowledge of payment posting procedures
- Ability to perform detailed clerical work in a methodical and thorough manner with accuracy
- Ability to perform mathematical calculations accurately and effectively

 

 


If the selection process for a future announcement is held within one year of the date of this examination and it includes any of these components [i.e., core exam or specialty subtest(s)], your score(s) for the corresponding test component(s) will be automatically applied to that announcement. However, after one year, you have the option to either (a) apply your test score(s) to the other announcement or (b) re-take the test component(s). Re-testing is permitted no sooner than one year from the date of the examination and only in association with your eligibility for another announcement for which the test component (core or specialty subtest) is used. Please note that, should you re-test, your re-test score would become your official score since it is the most recent.

These are standardized multiple-choice examinations. In accordance with Civil Service Rule 111.11.4, inspection privileges do not apply to the questions and answers in these examinations.

A passing score must be achieved on the written examinations in order to continue in the selection process. Candidates will be placed on the eligible list in rank order according to their written examination scores.

Certification:
The certification rule for the eligible list resulting from this examination will be Rule of Three (3) Scores. Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

Eligible List:
A confidential eligible list of applicant names that have passed the civil service examination process will be created, and used for certification purposes only. An examination score report will be established, so applicants can view the ranks, final scores and number of eligible candidates. Applicant information, including names of applicants on the eligible list, shall not be made public unless required by law. However, an eligible list shall be made available for public inspection, upon request, once the eligible list is exhausted or expired and referrals resolved. The eligible list/score report resulting from this civil service examination process is subject to change after adoption (e.g., as a result of appeals), as directed by the Human Resources Director or the Civil Service Commission.

The duration of the eligible list resulting from this examination process will be Twelve (12) Months, and may be extended with the approval of the Human Resources Director. 

 

 

 

Conviction History

As a selected candidate for a job, you will be fingerprinted, and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction (or arrest, in limited circumstances) conflicts with the specific duties and responsibilities of the job for which you are a selected candidate. If a conflict exists, you will be asked to present any evidence of rehabilitation that may mitigate the conflict, except when federal or state regulations bar employment in specific circumstances, such as:

  • Candidates for positions with the Unified School District and the Community College District may be disqualified from consideration should their conviction history not meet the standards established under the California Education Code.
  • Candidates for positions with the Recreation and Park Department may be disqualified from consideration should their conviction history not meet the standards established under California Public Resources Code 5164.

Having a conviction history does not automatically preclude you from a job with the City.

If you are a selected candidate, the hiring department will contact you to schedule a fingerprinting appointment.

Disaster Service Workers

All City and County of San Francisco employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the City requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

Conclusion

Note on ICARE: Willingness to uphold/abide by ZSFG’s ICARE (I-Introduce, C-Connect, A-Ask, R-Respond, E-Exit) philosophy for employee and patient interactions: https://zuckerbergsanfranciscogeneral.org/about-us/ttps://zuckerbergsanfranciscogeneral.org/about-us/.

Note on Electronic Health Record (EHR): The Department of Public Health (DPH) is implementing a unified Electronic Health Record (EHR) system and DPH employees must demonstrate competency in the use of the system that is appropriate for their classification as a condition of employment.

Note on Personal Protective Equipment (PPE): Some positions in the Department of Public Health will require the use of personal protective equipment (PPE), including but not limited to gloves, gowns, eye and face protection, and face-fitting respirators. The requirement for the use of PPE may come on short or no notice. Facial hair or any condition that interferes with a face-fitting respirator’s seal (i.e. comes between the sealing surfaces of the respirator and the wearer’s bare skin) is not permitted when face-fitting respirators are worn, including during initial or periodic respirator fit-testing.
Employees who choose not to shave and do not have either American Disabilities Act (ADA) or Equal Employment Opportunity (EEO) Accommodations do not have the right to alternate work assignments or the option of using a loose-fitting Powered Air Purifying Respirator (PAPR) in place of a FaceFitting Respirator.

Medical Examination/Drug Testing:
Prior to appointment, at the Department's expense, applicants may be required to take a tuberculosis (TB) screening test, a medical examination and/or drug test.

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 www.jobaps.com/sf.] 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 http://sfgov.org/civilservice/rules.

General Information concerning City and County of San Francisco Employment Policies and Procedures can be found at: http://www.sfdhr.org/index.aspx?page=20

Copies of Application Documents: http://sfdhr.org/getting-job#copies

Right to Work: http://sfdhr.org/getting-job#identification

Information on requesting a reasonable ADA Accommodation: http://www.sfdhr.org/index.aspx?page=20#applicantswithdisabilities

Information regarding requests for Veterans Preference can be found at:
http://www.sfdhr.org/index.aspx?page=20#veteranspreference

Information regarding Seniority Credit can be found at:
http://www.sfdhr.org/index.aspx?page=20#senioritycredit

Exam Type: CPE
Issued: October 11, 2019
Micki Callahan
Human Resources Director
Department of Human Resources
Recruitment No.: PBT-1636-903261
Department of Public Health
DPH / PC / (415) 554-2919

Benefits

All employees hired on or after January 10, 2009 will be required (pursuant to San Francisco Charter Section A8.432) to contribute 2% of pre-tax compensation to fund retiree healthcare. In addition, most employees are required to make a member contribution towards retirement, ranging from 7.5%-13.25% of compensation. For more information on these provisions, please contact the personnel office of the hiring agency.

For more information about benefits, please click here.



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