PATIENT RELATIONS REPRESENTATIVE

Position/Program Information

EXAM NUMBER

Y9197E

TYPE OF RECRUITMENT

We welcome applications from anyone!

APPLICATION FILING PERIOD

Filing will start effective March 4, 2025, at 12:30 p.m. (PT)

Filing will be suspended after the first 200 applications are received or by March 13, 2025, at 5:00 p.m. (PT), whichever occurs first.

Applications received after the first 200 or March 13, 2025, at 5:00 p.m. (PT) will not be considered.

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 25 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 $6.9 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.

Essential Job Functions

What are some of the responsibilities of a Patient Relations Representative?

Assesses and resolves complex patient issues related to primary care linkage, eligibility, billing for services, and managed care plan assignment. Researches 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.

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

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

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.

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.

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

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

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.

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.

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.

Prepares daily, weekly, and monthly patient service and activity reports for management’s review.

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

Requirements

REQUIREMENTS TO QUALIFY

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

To qualify, applicants must have County status as Patient Resources Worker as evidenced by holding or having held such payroll title for the required time.

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 EXPECTATIONS
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.

DESIRABLE QUALIFICATIONS:

• Additional experience beyond the Minimum Requirements.
• Experience interviewing the public to initiate or complete applications for financial assistance, charity care, or insurance for medical or mental health services.
• Thirty (30) semester units or forty-five (45) quarter units earned in an accredited college or university.

SPECIAL REQUIREMENT INFORMATION
In order to receive credit for the coursework, you must include a legible copy of the official diploma, official transcripts, or official letter from the accredited institution which shows the area of specialization, at the time of filing or within seven (7) calendar days from the date of filing application. Please submit documentation to ainiguez2@dhs.lacounty.gov and indicate your name, the exam name, and the exam number.

We do not accept password-protected documents. Ensure documents are unlocked before attaching to your application or sending to the exam analyst.

WITHHOLD INFORMATION

No withhold will be allowed. Required experience must be fully met at the time of filing and clearly indicated on the application.

ENDORSEMENT OF COUNTY QUALIFICATIONS
OUT-OF-CLASS experience will be accepted.

If you performed work that differs from the duties described in your class specification and you believe qualifies you for this opportunity, please describe the out-of-class duties in detail in the Work Experience and Supplemental Questions sections of their application. We also encourage you to submit any supporting documentation such as out of class/additional responsibility bonuses, verification of experience documents, and performance evaluations in order to assist our review of your qualifications.

Additional Information

OUR ASSESSMENT PROCESS

Examination content:

This examination will consist of an evaluation of experience, desirable qualifications and supplemental questionnaire based upon application information, weighted at 100%.

The passing score for the assessment is 70%.

ELIGIBILTY AND VACANCY INFORMATION:
Applications will be processed as they are received and added to the list accordingly. The list of successful candidates created from this exam will be used to fill vacancies throughout the Department of Health Services as they occur.

AVAILABLE SHIFT:
Appointees may be required to work any shift, including evenings, nights, weekends, and holidays.
APPLICATION AND FILING INFORMATION:
We only accept applications filed online. Applications submitted by U.S. mail, fax, or in person are not accepted. Apply online by clicking on the "Apply" green button at the top right of this posting. This website can also be used to get application status updates.

Please fill out the application completely. Provide relevant job experience including employer's name and address, job title, beginning and ending dates, number of hours worked per week, and description of work performed.

We may verify information included in the application at any point during the examination and hiring process, including after an appointment has been made. Falsification of information could result in refusal of application or rescission of appointment. Copying verbiage from the Requirements or class specification as your work experience will not be sufficient to demonstrate meeting the requirements. Doing so may result in an incomplete application and may lead to disqualification.

SOCIAL SECURITY NUMBER
Federal law requires that all employed persons have a Social Security Number, so include yours when applying.

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. Please refer to their website for updated information https://lacountylibrary.org/library-locator .

NO SHARING OF USER ID AND PASSWORD
All applicants must file their application 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 which are exempted by a valid court order do not have to be disclosed. Qualified applicants with arrest or conviction records will be considered for employment in accordance with County Fair Chance Policies and the Fair Chance Act (Gov. Code Section 12952).

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. We are 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:
Andrea Iniguez, Exam Analyst
ainiguez2@dhs.lacounty.gov
(213) 288-7000

TELETYPE PHONE:
(800) 899-4099

CALIFORNIA RELAY SERVICES PHONE:
(800) 735-2922

For detailed information, please click here

Closing Date/Time: 3/13/2025 5:00 PM Pacific

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• Los Angeles County

• (800) 970-5478

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