0931 Manager III - Director of Patient Accounts

Recruitment #PBT-0931-079765



Applicants are encouraged to file immediately as this recruitment may close at any time, but no earlier than December 7, 2017

Under general administrative direction of the Department of Public Health’s (DPH) 0941 Manager VI – Director of Patient Financial Services, the 0931 Manager III – Director of Patient Accounts is responsible for accounts receivable operations for Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), Laguna Honda Hospital and Rehabilitation Center (LHH), and multiple community clinics located throughout the City and County of San Francisco (CCSF).  Patient Financial Services Department operations involve patient registration from the following areas: Inpatient Admission, Emergency Department, Primary Care Clinics, Subspecialty Clinics, Ancillary Departments, and Psychiatric Emergency Services.  

The 0931 Manager III – Director of Patient Accounts performs the following essential job functions:

  • Coordinates with department heads of clinics and hospital administrators to ensure that medical services are completely described in the charge description master and to improve and optimize billing reimbursement for healthcare services rendered;
  • Works with the Information Technology Department to ensure that the billing software system is updated to: generate correct billing according to payer requirements, optimize the automated patient accounting process, and develop system monitoring tools to streamline operations and improve receivables;
  • Interacts with general accounting management to manage internal and external audits and reviews, etc.;
  • Provides the necessary vision and leadership to effectively motivate and direct staff in developing and achieving goals and objectives that are congruous with the mission and strategic plan of DPH and the San Francisco Health Network (SFHN);
  • Collaborates with the DPH Compliance Office to educate, monitor, and provide feedback to all hospital-based personnel and physicians regarding their involvement and effect on billing and regulatory compliance for services rendered;
  • Monitors billing systems for accuracy, timeliness, and functionality to ensure accounts receivable days are met;
  • Monitors system utilization and costs; recommends and facilitates new and current system development specific to departmental needs; identifies and communicates  system problems, enhancements, upgrades and/ or new system implementations to all relevant staff and departments;
  • Plans for and evaluates department productivity and financial reports to assess performance levels; identifies and mediates problem situations and analyzes cause(s); determines system  and staffing needs; coordinates assignments of responsibility; plans and assists with implementing courses of action;
  • Evaluates the performance of the Patient Accounting management team, including but not limited to: encouraging the development of their managerial and analytical skills; setting departmental goals and objectives that are focused on the economic viability of ZSFG; preparing timely, annual performance appraisals of departmental managers and supervisors and ensuring that all performance appraisals of staff are consistent with institutional policy;
  • Investigates and resolves patient billing dissatisfaction issues that are escalated to executive leadership and/or the Director of Patient Financial Services;
  • Promotes employee satisfaction by responding to and resolving personnel differences and concerns when management interactions remain unresolved; interfaces with DPH Labor analysts and union representatives to resolve labor/management issues and grievances;
  • Approves adjustments and refunds, within limits, in accordance with the DPH financial policy;
  • Anticipates and plans accordingly to respond to changes in the reimbursement environment and plans the appropriate procedures to be followed by the department to ensure maximum appropriate reimbursement for SFHN medical services rendered;
  • Establishes departmental policies based upon SFHN policies, external intermediary, and government and/or third party payer requirements; coordinates and negotiates the development of interdepartmental procedures in alignment with DPH/SFHN policies;
  • Develops and administers department budget; provides analysis and forecast of future needs for resources and staff based upon current, historical and projected needs and information; approves purchase orders and requisitions within limits established by DPH policy and to ensure budget expense control; and
  • Interacts with the CCSF Bureau of Delinquent Revenue for patient collections; coordinates outside vendor contracts; and interacts with the CCSF City Attorney's Office related to patient disputes.  

The 0931 Manager III – Director of Patient Accounts performs other related duties as assigned/required.  

Compensation and Benefits:  
The normal annual salary range is $117,078 – 149,448.  Appointment above the maximum of the normal range may be considered based on documented and substantiated recruitment and retention issues or exceptional skills.  A special approval process is necessary for appointment above the normal salary range.  

In addition to a competitive salary, the City and County of San Francisco offers flexible benefit plans with pre-tax elections which include:  medical and dental insurance; retirement plan; deferred compensation plan; Social Security; long-term disability plan; life insurance; management training program; eleven (11) paid holidays annually; five (5) floating holidays; depending on years of service, ten (10), fifteen (15), or twenty (20) vacation days annually; and may earn up to 100 hours paid administrative leave annually.  


Minimum Qualifications

  1. Possession of a Bachelor’s degree from an accredited college or university;  AND
  2. Five (5) years (equivalent to 10,000 hours) of professional experience in functional areas related to patient finance, eligibility, or compliance in a healthcare setting.  Qualifying experience must include three (3) years (equivalent to 6,000 hours) of experience supervising eligibility, admitting, patient accounts, or other closely related professionals (e.g. healthcare billing, etc.).  

Substitution:  Additional professional experience as described above may be substituted for the required degree on a year-for-year basis. Thirty (30) semester units or forty-five (45) quarter units equal one (1) year.

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

Desirable Qualifications:
The stated desirable qualifications may be used to identify job finalists at the end of the selection process when candidates are referred for hiring.

  • Knowledge of government and non-government payers such as Medicare, Medi-Cal, Federally Qualified Healthcare Clinic (FQHC), Workers’ Compensation, Commercial Insurance, and Health Maintenance Organizations (HMOs)
  • Knowledge of current federal and state regulations related to healthcare and charity programs
  • Experience in a large hospital medical center providing the following services:  acute inpatient skilled nursing facility, acute psychiatric skilled nursing facility, acute rehabilitation, and an acute psychiatric service unit
  • Experience with pro fee billing
  • Strong analytical and organizational skills
  • Ability to adjust to changes in operations in order to meet program needs
  • Willingness to uphold/abide by ZSFG’s ICARE (I-Introduce, C-Connect, A-Ask, R-Respond, E-Exit) philosophy for employee and patient interactions

Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. If education verification is required, information on how to verify education requirements, including verifying foreign education credits or degree equivalency, can be found at

Note: Falsifying one’s education, training, or work experience or attempted deception on the application may result in disqualification for this and future job opportunities with the City and County of San Francisco.

Verification of required education typically must be a photocopy of the degree or transcript from an accredited college or university.  

Verification of required work experience typically must be on the employer’s letterhead, and must include the applicant’s name, job title, description of job duties, dates of employment, hours per week, and signature of the employer, supervisor, or appropriate representative.  City and County of San Francisco (CCSF) employees do not need to submit verification of their City employment, but must submit written verification of outside experience. CCSF employees will not receive credit for experience obtained outside of their classification unless recorded in accordance with the provisions of the Civil Service Rule 110.9.1/111A.11.2.     

Verification of required licensure/certification typically must be a photocopy of the license/certificate including the name of the issuing agency as well as the name of the license/certificate holder, license/certificate number, and expiration date.

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 exam analyst, Yvette Gamble, by telephone at (415) 554-2911 or by email at yvette.gamble@sfdph.org 

Selection Procedures

Supplemental Questionnaire Evaluation: (Weight: 60%)
Applicants will be prompted to complete a Supplemental Questionnaire as part of the online application process and it must be submitted with the application by the final filing deadline.  The information provided on the Supplemental Questionnaire must be consistent with the information on the application and is subject to verification.  Applicant responses to the Supplemental Questionnaire will assist with determining if you meet the minimum qualifications for the position. Once submitted, applicant responses on the Supplemental Questionnaire cannot be changed.   

The Supplemental Questionnaire Evaluation is also designed to measure knowledge, skills, and/or abilities in job-related areas which may include, but not be limited to:   

  • Knowledge of evolving government programs and regulations related to managing patient financial services  (e.g. the Joint Commission, Health Insurance Portability and Accountability Act of 1996, Medicare Secondary Payer, Federally Qualified Health Center Program, etc.)
  • Knowledge of software applications and/or programs related to healthcare financial systems; expertise in utilizing software applications to maximize automation and efficiency in registration and patient accounting functions
  • Ability to integrate information from a variety of sources and focus on future developments to achieve best outcomes
  • Ability to analyze situations and issues in general systems fashion, identifying contributing factors, processes occurring, and resulting outcomes, while recognizing opportunities for change that result in improvement
  • Ability to design productivity management systems and controls to identify productivity deficits and improve outputs
  • Excellent mathematical abilities, including but not limited to the ability to calculate rate, ratio, and percent; interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables
  • Ability to manage large numbers of staff engaged in healthcare related patient accounting duties, including professional healthcare billing clerks, revenue analysts, and other related employees; ability to effectively organize and assign work; give guidance and direction to others and follow-up to ensure completion; counsel and motivate subordinates
  • Strong ability in healthcare billing and collection practices and procedures; ability to ensure that billing practices adhere to government billing compliance standards
  • Ability to communicate effectively orally and in writing, mounting logic-based arguments when in-depth understanding or persuasion are necessary  

Management Test Battery: (Weight: 40%)
Candidates will be invited to participate in a computer-based examination designed to measure competencies in job-related areas which may include but not be limited to: Problem Solving; Leadership; Decision Making; Interpersonal skill; Human Resources Management; Team Building; Communication; Conflict Management and Process Improvement. For more information about this Management Test (and a suggested reading list) please visit: http://www.sfdhr.org/index.aspx?page=343

A passing score must be achieved on the Management Test Battery in order to continue in the selection process.

This is a standardized examination and, therefore, test questions and answers are not available for public inspection or review.

Scores attained on the Management Test Battery will be valid and 'banked' for three years, starting from the date of the examination. This means that, during this three-year time period, you will not be required to take the Management Test Battery. The Management Test Battery may be used for many other classes; therefore your test score may be applied to one or more of these classes if you choose to apply to future recruitments. If the selection process for the future announcement is held within one year of the date of this examination and it includes the Management Test Battery, your score will be automatically applied to that announcement. However, after one year, you have the option to either (a) apply your test score to the other announcement or (b) re-take the Management Test Battery. 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 Management Test Battery is used. Please note that, should you re-test, your re-test score would become your official score since it is the most recent.

In order to be ranked on an eligible list, qualified applicants must achieve a passing score on both examination components.  Successful applicants will be placed on an eligible list, in rank order, according to their final score.  

After the eligible list is finalized/adopted:

  • The department may administer additional selection procedures to make a final hiring decision (e.g. interviews, written exercise, etc.). 
  • Applicants meeting the Minimum Qualifications are not guaranteed advancement through all steps of the selection process.   

The certification rule for the eligible list resulting from this examination will be Rule of the List.  Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

Eligible List:
The eligible list resulting from this examination 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 six (6) months, and may be extended with the approval of the Human Resources Director.

Upon approval of the Human Resource Director (see Civil Service Rule 111A.26.5), the eligible list resulting from this announcement may be used by other departments that also use this classification or a similar classification.  To find other Departments which use this classification, please see http://www.sfdhr.org/Modules/ShowDocument.aspx?documentID=21246. Search that document by title or job code to see which departments use the classification.

Conviction History

As a finalist 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 finalist. 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 applying 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 applying 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 selected as a finalist, 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.



Valid licensure/certification/registration as a requirement to perform the job must be kept current throughout duration of employment. Failure to demonstrate/show proof of possession of required valid licensure/certification/registration may result in dismissal and/or termination of employment.   

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 Face Fitting Respirator.  

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

Terms of Announcement:
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.  Clerical errors may be corrected by the posting the correction on the Department of Human Resources website at www.jobaps.com/sf.

The terms of this announcement may be appealed under Civil Service Rule 111A.35.1. The standard for the review of such appeals is ‘abuse of discretion’ or ‘no rational basis’ for establishing the position description, the minimum qualifications and/or the certification rule.  Appeals must include a written statement of the item(s) being contested and the specific reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director.  Appeals must be submitted directly to the Executive Officer of the Civil Service Commission within five business days of the announcement issuance date.

General Information concerning City and County of San Francisco Employment Policies and Procedures:
Important Employment Information for the City and County of San Francisco can be obtained at http://sfdhr.org/information-about-hiring-process or hard copy at 1 South Van Ness Avenue, 4th Floor.

Copies of Application Documents:
Applicants should keep copies of all documents submitted, as these will not be returned.

Right to Work:
All persons entering the City and County of San Francisco workforce are required to provide verification of authorization to work in the United States.

Applicants with disabilities who meet the minimum eligibility requirements for this job announcement can find information on requesting a reasonable ADA Accommodation at: 

Information regarding requests for Veterans Preference can be found at: 

Seniority Credit in Promotional Exams: 
Information regarding seniority credit can be found at:

Exam Type:  CPE
Issued:  November 22, 2017
Micki  Callahan
Human Resources Director
Department of Human Resources
Recruitment ID Number: PBT-0931-079765
DPH/YG/(415) 554-2911  (#01106396, MCCP#  81-004)


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.


Powered by JobAps