PATIENT RELATIONS REPRESENTATIVE/COMMUNITY PROGRAMS

Job Description:

PATIENT RELATIONS REPRESENTATIVE/COMMUNITY PROGRAMS

Description

Position/Program Information

EXAM NUMBER

Y9197E-EA

TYPE OF RECRUITMENT

OPEN COMPETITIVE - EMERGENCY

APPLICATION DATE

September 24, 2024, at 8:00 a.m., (PT)

This opportunity will remain open until the needs of the services are met and is subject to closure without prior notice.

NO OUT-OF-CLASS EXPERIENCE OR WITHHOLDS ARE ALLOWED FOR THIS EXAMINATION.

The LA County Board of Supervisors recently declared a local state of emergency for homelessness, and the County is working to revise and expand our response to help all who are affected. We are looking for qualified and passionate individuals to help us in the mission of addressing issues like housing, mental health, and substance use. If you are looking for a new career that will directly benefit the population of LA County, this may be the opportunity for you.

Department of Health Services Community Programs (Housing for Health for Homelessness) and Office of Diversion and Reentry seek qualified candidates to fill emergency Patient Relations Representative vacancies within Health Services Community Programs related to the homelessness crisis.

Under the emergency order, applicants who meet the requirements may be hired for an initial period of up to 90 days, with an opportunity for permanent County employment.

Before your initial work period ends, you will be assessed on your work performance. This assessment will be weighted 100%.

Those who successfully pass the assessment will be considered for permanent appointment as Patient Relations Representative in Health Services Community Programs.

ABOUT LOS ANGELES COUNTY DEPARTMENT OF HEALTH SERVICES:
The Los Angeles County Department of Health Services (DHS) is the second largest municipal health system in the nation. Through its integrated system of 26 health centers and four hospitals - and expanded network of community partner clinics - DHS annually provides direct care for over 600,000 unique patients, employs over 23,000 staff, and has an annual budget of over $6.5 billion. For additional information regarding DHS please visit www.dhs.lacounty.gov .

Through academic affiliations with the University of California, Los Angeles (UCLA), the University of Southern California (USC), and the Charles R. Drew University of Medicine and Sciences (CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In addition, to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the County's 911 emergency response system, as well as Housing for Health and the Office of Diversion and Re-entry, each with a critical role in connecting vulnerable populations, including those released from correctional and institutional settings to supportive housing.

MISSION:
To advance the health of our patients and our communities by providing extraordinary care.
DEFINITION:
Performs complex and specialized patient access and patient relations functions and leads lower-level patient resources workers.

CLASS IFICATION STANDARDS Positions in this class typically report to a Supervising Patient Financial Services Worker I or higher-level supervisor. Incumbents work under general supervision and are assigned to complex and specialized patient relations cases related to primary care linkage, health plan assignment and enrollment, authorization and continuity of care, and other related customer service and operational issues. They serve as resource specialist and may be assigned to multiple areas, including the Emergency Department (ED), Urgent Care or other day-of registration clinics, patient relations, call centers, or insurance authorization units. Positions are assigned to lead lower-level Patient Resources Workers, and may screen, initiate, and refer patients with Medi-Cal linkage to eligibility workers for further processing and determination.

This class is distinguished from other health care classes in that they offer enhanced one-on-one patient services by resolving complex cases following intricate State, Federal, departmental and facility-based policies, procedures, and guidelines related to patient access. Positions require considerable knowledge of the different health insurance coverage types and programs, managed care rules and contracts, and internal policies to determine a patient’s options for accessing services. Incumbents in this class must have expertise in patient scheduling and registration workflows and procedures.

Essential Job Functions

Assesses and resolves complex patient issues related to primary care linkage, eligibility, billing for services, and managed care plan assignment. Research errors and patient issues, and takes proper action to satisfy those needs by responding to member questions.

Assists health care plan members in their interaction with medical care providers, administrative personnel, and third-party payers.

Serves as liaison between patients, medical personnel, managed care plans, independent practice associations, insurance companies, case managers, utilization review personnel, and Medi-Cal eligibility workers.

Listens, identifies, and recommends health options and services to help meet patients’ needs. Obtains demographic, financial and insurance information. Provides forms to patients and completes paperwork for requested services.

Research grievances with hospital administration, physicians, nurses, and other patient support staff; refers inquiries to appropriate department or clinic for response.

Enrolls, dis-enrolls, or transfers members.

Schedules patient visits by determining the appropriate providers and programs for patients. Ensures timely access to services by actively monitoring and coordinating multiple provider schedules and maintaining appointment templates for clinic providers.

Assigns, coordinates, and reviews the work of lower-lever personnel in the unit, ensuring proper work methods are followed. Provides technical assistance and training.

Answers and documents incoming calls from patients or providers or greets walk-in members who have concerns surrounding medical care issues.

Accesses patient information from a variety of medical plan systems and files for reference purposes and uses computer systems to track and document all complaints and outcomes.

Re-verifies eligibility in the month of the appointment to financially clear patients for appointments, conducts patient outreach by phone and/or mail, explains coverage options to patients, refers the patient to member services as needed, and cancels appointments. Checks-in patient for appointment to explain payment options and obtains signatures and collects and keep records of insurance and patient identification.

Manage/build provider and clinic templates -Design Change Worksheets (specialized work) working alongside clinicians and Cerner to complete the request as assigned.

Applies various rules and regulations of Medicare, Medicaid, Managed Care, and commercial payers regarding referrals, authorizations, and certifications.

Performs general office duties, such as answering multiple lines, making appointment reminders, copying, filing, scanning, and faxing.

Initiates and/or processes applications for a variety of reduced no-cost/low-cost programs, such as Ability to Pay, Ryan White/Casewatch, Family Planning Access Care Treatment (Family PACT) program, Uniform Method of Determining Ability to Pay, and Hospital Presumptive Eligibility.
Prepares daily, weekly, and monthly patient service and activity reports for management’s review.

Requirements

MINIMUM REQUIREMENTS:
Option I: Two (2) years of experience in the service of the County of Los Angeles as a Patient Resources Worker.

Experience must have been gained while holding the payroll title of Patient Resources Worker to receive credit towards meeting the Minimum Requirements.

Option II: Three (3) years of experience in a healthcare setting at the level of Patient Resources Worker which includes identifying 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 with responsibility for performing patient access related work in Emergency Department/Urgent Care registration or other walk-in registration, admitting, financial screening and eligibility verification, and scheduling areas.

Patient Access experience includes but is not limited to experience in Patient Access Coverage Verification & Financial Screening, Emergency Department or Urgent Care Registration and Coverage Verification, Patient Relations (including Empanelment/Primary Care Linkage), and Call Center (for patient scheduling of primary care, specialty care, and diagnostic appointments).

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 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.

Additional Information

OUR ASSESSMENT PROCESS:

Before the end of your initial work period, the appointing department will evaluate your performance. Those who achieve a passing score on this evaluation will be considered for permanent appointment.

ELIGIBILITY INFORMATION:

Please note that ALL information 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. FALSIFICATION of any information may result in DISQUALIFICATION.

VACANCY INFORMATION:

The current vacancies are to be filled within Community Programs (Housing for Health for Homelessness).

AVAILABLE SHIFT: Appointees may be required to work any shift, including evenings, nights, weekends, and holidays.

APPLICATION & FILING INFORMATION:

Applications must be filed online only.

Many important notifications will be sent electronically to the email address provided on the application, so it is important that you provide a valid email address. Please add the following email addresses to the list of approved senders to prevent email notifications from being filtered as spam/junk/clutter mail.

mbecerra5@dhs.lacounty.gov

noreply@governmentjobs.com

info@governmentjobs.com

You can opt out of emails from LA County. If you unsubscribe, you will not receive email notifications for any examination you apply with Los Angeles County.

Regardless of whether you choose to unsubscribe, you can always check for notifications by logging into governmentjobs.com and viewing your profile inbox, which saves a copy of all emailed notices.

Plan to submit your online application in a timely manner, 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 www.governmentjobs.com/careers/lacounty, you can verify at any time by logging in and following the prompts. This will enhance the security of your online application and ensure you do not enter an incorrect email address.

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.

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.

NO SHARING USER ID AND PASSWORD:

All applicants must file their applications 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.

FAIR CHANCE INITIATIVE:

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 exempted by a valid court order do not have to be disclosed.

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 inequalities and disparities amongst races. We support the ARDI Strategic Plan and its goals by improving equality, diversity, and inclusion in recruitment, selection, and employment practices.

DEPARTMENT CONTACT:

Miguel Becerra

mbecerra5@dhs.lacounty.gov

(213) 288-7000

ADA COORDINATOR PHONE: (323) 914-7111

TELETYPE PHONE: (800) 899-4099
CALIFORNIA RELAY SERVICES PHONE: (800) 735-2922

For detailed information, please click here

Salary:

$50,009.52 - $67,389.84 Annually