Patient Benefits Specialist

Under general direction, interviews Mental Health clients and their families to assess financial status and determine potential eligibility for Federal, State and County assistance; performs related duties as required. 

Patient Benefits Specialist is located in the Mental Health Division of the Health and Social Services Department.  It is characterized by the responsibility to interview severely mentally ill clients to elicit financial information.  Patient Benefits Specialist is distinguished from the Eligibility Benefits Specialist series in that the latter is responsible for determining initial and continuing eligibility of applicants for public assistance programs.

Interviews Mental  Health  clients  in  acute   psychiatric hospitals   and  other  facilities  to  determine  potential  for eligibility for Federal, State and  County  assistance  including County Medical Services Program (CMSP),  Medi-Cal,  Social Security Income (SSI), StateDisability Insurance(SDI), Short-Doyle or to investigate existing health insurance coverage.  Works with client and/or client's family to complete applications for CMSP, SSI, SDI,Short-Doyle and Medi-Cal and obtains needed verifications for CMSP or Medi-Cal application approval. 
 
Interprets provisions and requirements of Federal, State and County aid programs to patients and explains their rights and obligations with regard to financial coverage for medical services; submits CMSP or Medi-Cal applications to the Health and Social Services Department, Eligibility Division for processing; contacts Health and Social Services Department Eligibility Benefit Specialists to provide verification for application approval; contacts the Health and Social Services Department for  the  Napa  Liaison Office  to  obtain  information regarding needed verification and submits such verifications for immediate need grants on  Medi-Cal pending  applications for clients who need placement in long term facilities. 
 
Refers clients to the Social Security Administration and Health and Social Services Department to determine patients' eligibility for medical coverage and initiates the necessary financial documents within time limits specified by the agency. 
 
Reviews billings for client pharmacy and ambulance usage; contact hospital accounting departments to notify them of CMSP or Medi-Cal approval; provides hospitals with billing information concerning client insurance coverage and related billing problems; tracks clients to insure continued eligibility; establishes and maintains files for each client; insures completeness of client application and records. 
  
Reviews and summarizes patient admissions, discharges and utilization data; prepares reports to summarize activity within County's contract with private hospitals; prepares vendor claims to free standing psychiatric facilities; prepares other reports as requested. 
  
Provides information and makes routine referrals to resources available through the County and within the community which help meet mental health needs; acts as patient benefit liaison between Solano County Mental Health Services and County contract hospitals, Health and Social Services Department, Social Security Administration, Department of Veterans Affairs and the Public Guardian's Office.

A minimum of one year of public contact experience, equivalent to an Eligibility Benefits Specialist I or Employment Resources Specialist I, which involved processing financial or personal history documents and interpreting applicable laws, rules, and regulations which demonstrates possession of and competency in requisite knowledge and abilities
 
Completion of 60 semester or 90 quarter units from an accredited college or university preferably in general education, business, finance, social science, or a closely related field may be substituted for the one year of required experience.

This Supplemental Questionnaire will be used to determine applicants’ qualifications for this position and whether they will continue in the recruitment process; therefore, applicants are encouraged to answer all questions thoroughly and completely.  Omitted information will not be considered or assumed.  Applicants who have no experience in a specific area are recommended to state "no experience in this area" instead of leaving the space blank.

1) Do you have a minimum of one year of public contact experience that involved processing financial or personal history documents and interpreting applicable laws, rules, and regulations?

__ Yes __ No

2) Have you completed the equivalent of 60 semester units from an accredited college or university?

__ Yes  __ No

3) Describe your experience processing financial or personal history documents and interpreting applicable laws, rules, and regulations.

4) Describe your experience interviewing severly mentally ill individuals and their families to elicit financial information.

 

Possession of or ability to obtain a valid Class C California driver's license is required.

Independent travel will be required.
 
Selectees for employment must as a condition of employment sign a statement agreeing to comply with Section 11166 of the California Penal Code relating to child abuse reporting.

04/18/2014 Final application filing date. Deadline to submit all required materials
04/28/2014 Tentative date for review of applications.
05/06/2014 Tentative Date for Oral Board
05/08/2014 Tentative date for Human Resources to establish eligible list and certify names to hiring department.

SALARY POLICIES - The starting salary is ordinarily the first rate shown on the front of the announcement.  Salary advancement is authorized after satisfactory completion of additional periods outlined in the employee’s memoranda of understanding or the County’s Personnel and Salary Resolution.  Longevity, shift differential, bilingual, call-back and stand-by pay maybe available for some job classes. 

HOLIDAYS – Regular and limited-term employees receive 12 paid holidays per year.

ANNUAL/SICK LEAVE - Regular and limited-term employees accrue vacation leave at the rate of ten days per year.  After a certain period of continuous service, employees accrue vacation time at a higher rate as outlined in the employee’s memoranda of understanding or resolution. Regular and limited-term full time employees accumulate 12 sick leave days per year.

RETIREMENT – Non-Safety – Employees who have never been a member of any public retirement system prior to January 1, 2013, or who have moved between retirement systems and were not subject to reciprocity, or who have moved between public employers within a public retirement system after a break in service that is greater than six months are eligible for a miscellaneous retirement plan of the 2% at age 62 benefit formula.  Employees entering membership in Solano County’s miscellaneous retirement plan on or after May 4, 2012 but before January 1, 2013, or who have moved between public employers within a public retirement system with a break in service that is less than six months are eligible for a 2% at age 60 benefit formula.  Employees entering membership in Solano County’s miscellaneous retirement plan prior to May 4, 2012 are eligible for a 2.7% at age 55 benefit formula. 

HEALTH BENEFITS - Employees and their dependents are eligible for vision and dental insurance with 100% of the cost paid by the County of Solano.  The County also participates in a cafeteria medical plan administered by PERS HealthCare (eligibility is dependent upon job class). 

OTHER BENEFITS – Employees may also elect to participate in deferred compensation, credit union, life insurance, and flexible spending plan.  All County employees are eligible to purchase auto and/or home owners, renter insurance from Liberty Mutual Insurance.  An Employee Assistance Program is also provided.

EXTRA-HELP - Extra-help employees do not receive or accrue benefits of regular employees during their period of employment.

Based on the information provided in the application documents, the qualified applicants will be invited for further examination. All applicants meeting the minimum qualifications are not guaranteed advancement through any subsequent phase of the examination. Depending upon the number of applications received, the selection process may consist of an initial application screening, a mandatory information meeting, a written and/or practical exam, a supplemental questionnaire, an oral interview, or any combination listed. Information contained herein does not constitute either an expressed or implied contract.

All potential new hires and employees considered for promotion to management, confidential positions or unrepresented positions will be subject to a background and reference check.  These provisions are subject to change.

A minimum score of 70% is required to continue in the selection process.

All additional application materials as requested in the job announcement (e.g. copies of diploma and/or transcripts, certificates, DD-214) must be submitted with a document cover sheet, available on the employment website or at the Department of Human Resources’ office,  and are due by the final filing date.  Previously submitted application materials (e.g., copies of diploma and/or transcripts, etc.) for prior recruitments will not be applied for this recruitment but must be re-submitted for this recruitment.  

Please visit the County of Solano website, www.jobsatsolanocounty.com to apply.  Any further questions can be directed to the Department of Human Resources at (707) 784-6170 or at 675 Texas Street, Suite 1800 Fairfield 94533.  The office is open Monday-Friday, 8:00 a.m.-5:00 p.m.  Paper applications may be completed in person during office hours. EOE/AA

To be eligible, applicant must have served at least 181 consecutive days of active duty in the Armed Forces of the United States and have received either an honorable discharge or a general discharge under honorable conditions.  A COPY OF THE DD 214, SHOWING DISCHARGE TYPE, MUST BE RECEIVED IN THE HUMAN RESOURCES DEPARTMENT BY THE FINAL FILING DATE.  Applicants who have a service connected disability must submit a recent award letter from the VA stating they are receiving disability benefits for service connected reasons.  Disability must be rated at least 10% to be eligible for disabled veteran's points. 

Veteran applicants for initial County employment with an honorable or general under conditions discharge shall receive five (5) points added to their combined grade.  Disabled veterans shall have 10 points added to their combined grade.  Veteran scores will only be added to passing scores. 

It is the policy of Solano County that all employment decisions and personnel policies will be applied equally to all County employees and applicants and be based upon the needs of County service, job related merit, and ability to perform the job.

APPLICANTS WITH DISABILITIES:  Qualified individuals with a disability, who are able to perform the essential functions of the job, with or without reasonable accommodation, and need special testing arrangements, must contact the Solano County Department of Human Resources at (707)784-6170, to obtain a Request for Testing Accommodation by Applicants with Disabilities Form.  This form must be received in the Human Resources Department by the final filing date of the recruitment.  Applicants will be contacted to discuss the specifics of the request.

DIRECT DEPOSIT: All persons hired will be required to participate in the direct deposit program.

DRUG FREE WORKPLACE ACT – Depending on the applicant’s job class, prospective employees may be required to undergo a Urine Drug Test in accordance with the Solano County Alcohol and Drug Free Workplace Policy once a conditional offer of employment has been made. Solano County employees are subject to the provisions of the Drug Free Workplace Act of 1988 and the California Drug-Free Workplace Act of 1990.

RETIREES - Solano County invites all to apply for positions; however pursuant to Government Code Section 21221(h) and 21224, hiring restrictions may apply to California Public Sector Pension Plan Retirees. 

BACKGROUND PROCESS –The background process may include but not limited to conducting a reference check, completing a personal history statement, conducting a background interview, and live scan fingerprinting.  The County of Solano also utilizes e-Verify to verify employment eligibility.  Note:  A felony conviction will not necessarily disqualify an applicant from employment.    The County will consider the nature, date and relationship between the offense and the position for which you are applying.

MEDICAL EXAMINATION - Prior to appointment, candidates may be required to pass a medical examination.  Candidates are encouraged not to quit or give notice to present employers until the medical examination has been completed and passed.

APPOINTMENT - At the time of appointment, all candidates will be required to execute an oath of allegiance to the United States and the State of California and may be fingerprinted.  Candidates will also be required to offer proof that they are a lawfully admitted alien or U.S. citizen.

PROBATIONARY PERIOD - All new positions are required to successfully complete a minimum probationary period of 6 to 12 months, depending upon the job class.  A probationary period does not apply to "at will" positions.

DISASTER WORKERS - In accordance with Government Code Section 3100, County employees, in the event of a disaster are considered disaster workers and may be asked to respond accordingly.

EXTRA-HELP – An employee appointed to an extra-help position must meet all the requirements of the corresponding regular position.  Extra-help employees cannot work more than 999 hours in the fiscal year.  Extra-help employees are excluded from civil service and do not have rights to regular or continued employment.

The provisions of this bulletin do not constitute an expressed or implied contract.  Any provision contained in this bulletin may be modified or revoked without notice.

"SOLANO COUNTY IS AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER"