According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job code/class and are not intended to be an inclusive list.
1. Explain programs, qualification standards, policy and procedure to patients; assist patients in completion of applications and forms when necessary; review and evaluate applications for completeness and accuracy; prepare patient budget to determine eligibility.
2. Conduct interviews with patients, their relatives and others in order to identify and determine patient eligibility for coverage of medical care under various Federal or State programs or under the provisions of private, fraternal, union or other health care plans; verify hospitalization insurance and arrange for billing of the appropriate agency or health care plan; continually reviews patient's case files to update vital statistics.
3. Obtain and provide medical and financial information with hospital staff, outside government agencies, and insurance providers; attend ward rounds with appropriate staff.
4. Determine patient eligibility for a third party payment source according to established policies and procedures including private health insurance plans, victims of crime, workers' compensation, and lawsuit settlements.
5. Initiate and obtain approval of extension of Medi-Cal coverage for emergency and elective admissions.
6. Prepare records related to patient eligibility information and health care payment received; update records; submit required reports.
7. Investigate statements and information received from applicant through the use of telephone or written verifications.
8. Review cases with supervisor in assessing the quality of payment source determination process and procedure.
9. Compose and prepare correspondence to patients, references, and State agencies; gather statistical data and prepare reports as required.
10. When assigned to a long term care facility, may regulate patient finances to maintain patient eligibility and entitlement to various benefits; may facilitate burial arrangements and final disposition of estate.
11. Refer non-payment cases to appropriate authority for recovery.
12. Answer questions and provide information to patient and the general public regarding assigned program area.
13. Assist in registering patients into the hospital; provide assistance to patients in completing applications; make referrals to Social Service agencies.
14. Perform related duties as required.