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` POSITION ADJUSTMENT REQUEST No.
Date: May 13, 1986
Dept. No./ -- - - Copers
Department Health Svc/Finance Budget Unit No. 0540 Org. Nq. Agency No. 54 _
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Action Requested: Reallocate Clerk - Experienced Level position #54-1687 n c�Lnt Mprk
Beginning Level. C!\!I ,- -
Proposed Effective Date: 6/18/86
Explain why adjustment i-, needed: Tn prmeriv claccifv tha ,nr•,mhant (j
Lopez)
-_n the
Inpatient Transfer Unit of the Pati ent Acrrnnni-i ng rlf f i'rc
Classification Questionnaire -nttached: Yes No
Estimated cost of adjustment: $ 0 (same sa
Cost is within department's budget: Yes [3 No E] eve
If not within budget., use reverse side to explain how costs are to be funded.
Department must initiate necessary appropriation adjustment. Web Beadle, I�
Use additional sheets for further explanations or comments, IXP=tmentparyonzaQr
r epar men ead
Personnel Department Recommendation
Date:
Reallocate Clerk - Experienced Level position #54-1687, Salary Level C5 1023
(1264-1536) to Account Clerk - Beginning Level , Salary Level C5 1023 (1264-1536) .
Amend Resolution 71/17 establishing positions and resolutions allocating classes to the
Basic/Exempt Salary Schedule, as described above.
Effective: day following Board action.
Date for Director o rsonnel
County Administrator Recommendation
Date: �•-/0 -�lo
)(- Approve Recommendation of Director of Personnel
Disapprove Recommendation of Director of Personnel
Other:
for) County Administrator
Board of Supervisors Action JUN 17 1986 Phil Batchelor, Clerk of the Board of
Adjustment APPROVED/i)-P •ED on Supervisors and County Administrator
Date: JUN 17 1986
By: 1paAVL�
APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT.
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COMMENTS OF IMMEDIATE SUPERVISOR
Do you concur or disagree with the statements of the employee? If you disagree, be
specific as to why.
Yes, I concur with the statement she has made. Her desk is a revenue
generating desk for Health Services and coda-ins a great number of complexities.
What parts of this job do you check or review closely and why?
Jeanette Lopez is well trained anddoes not need close reviewing. Spot checking
is done to see if the Inpatient transfer folders are moving to the
billing area on a timely basis. Regulation changes, office procedure
changes are dicussed at meetings or announced in memo form.
(Signature � �� -�-- C�-''��.e, (Date) NZ'"
COMMENTS OF DEPARTMENT HEAD / DESIGNEE
Comment on the statements of the employee and supervisor. If you disagree with the
employee and/or supervisor, be specific.
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(Signature) (Date)
JEANETTE LOPEZ
' EMPLOYEE NAME
1 . What is the function of your work unit? WE GATHER ALL NECESSARY BILLING INFORMATION
FOR MEDI-CAL, MEDICARE, PRIVATE PAY, INTERDEPARTMENTAL A14D HEALTH PLAN FOR ALL
INPATIENTS SEEN AT CONTRA COSTA COUNTY MEDICAL FACILITY.
2. For whom or for what group are you providing accounting clerical support?
CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT-PATIENT ACCOUNTING DEPARTMENT-
INPATIENT TRANSFER UNIT
3. Designate the name and title of the person who supervises your position.
How is your work reviewed? BARBARA BOUCHET - SUPERVISING ACCOUNT CLERK,
MY WORK IS REVIEWED BY COMPLETING A WEEKLY LOG WITH TOTALS OF ALL CLAIMS HELD ON
MY DESK.
4. Where is your supervisor located in proximity to your desk?
APPROXIMATELY 30 FEET FROM MY DESK. THE TRANSFER UNIT IS 2N THE BACK AREA OF THE
BUILDING. MY SUPERVISOR IS LOCATED IN THE BILLING UNIT, LOCATED IN THE MIDDLE OF
THE BUILDING.
5. What are the most important assignments you perform and why? I NEED KNOWLEDGE OF VARIOUS
STATE, COUNTY AND FEDERAL PROGRAMS AND OBTAIN ALL BILLING INFORMATION NEEDED SPECIFIED
BY THESE RULES AND REGULATIONS. I MUST KEEP UP ON ALL THE CONSTANT CHANGES IN BILLING
PROCEDURES OF ALL THE DIFFERENT PROGRAMS. I MUST BE AWARE OF WHAT IS SITTING ON MY DESK
AT ALL TIMES AND MUST PROCESS AS QUICKLY AS POSSIBLE IN ORDER TO MEET DEADLINES. I REVIEF
ALL CHARGES AND REQUEST CREDITS OR NEW CHARGES. I DO COMBINATIONS ON ACCOUNTS. I CALL
ELIGIBILITY WORKERS FOR MEDI-CAL ELIGIBILITY. I COMPLETE. SHARE. OF COST FORMS.
6. What is the most difficult or complex work you perform and why? BEINr AWARE: OF THE
RULES AND REGULATIONS AND CONSTANT CHANGES IN ALL THE VARIOUS COUNTY, STATE AND FEDERAL
PROGRAMS. OBTAINING ALL NECESSARY BILLING INFORMATION FROM SOCIAL SERVICES AND OTHER
DEPARTMENTS IN THE HOSPITAL. I HAVE TO MAKE SURE WE ARE BILLING THE RIGHT SOURCE AS
MANY OF OUR PATIENTS MEDICAL COVERAGE CHANGES FREQUENTLY, I MUST SEE THAT ALL BILLING
DEADLINES ARE MET. GIVING LEAD DIRECTION FOR ANY FINANCIAL CLASS CHANGES, WRITE OFFS
OR ANY ADJUSTMENTS NEEDED ON AN INPATIENT ACCOUNT, VERIFYING MEDICARE ELIGIBILITY.
7. What parts of your job involve the greatest responsibility and why? NOTIFYING, DEPART-
MENTS IN THE HOSPITAL OF INSURANCE INFORMATION CHANGES WHICH REQUIRE A FINANCIAL CLASS
CHANGE AND REQUESTING THE NECESSARY BILLING FORMS TO GO WITH THE CHANGE. I MUST BE
AWARE AT AL.L'TIMES OF ALL THE ACCOUNTS SITTING ON MY DESK. I MUST ALSO BE AWARE OF
EXACTLY WHAT INFORMATION IS NEEDED TO COMPLETE THE INPATIENT FOLDER AND HOW TO OBTAIN
THE MISSING INFORMATION AND FORMS IN ORDER TO MAKE ANY NECESSARY ADJUSTMENTS. I MUST
GET THE COMPLETED FOLDER TO AN ACCOUNT CLERK III TO BILL BEFORE THE DEADLINE. I MUST
DIRECT THE ACCOUNT CLERK III TO COMPLETE ANY COMBINATIONS OR ADJUSTMENTS.
8. List the name and job titles of employees to whom you are assigned to provide
lead direction. ( PROVIDE INSTRUCTION BUT NOT SUPERVISION ON A DAY TO DAY BASIS.)
FINANCIAL COUNSELING DEPARTMENT CAROL RAINOS - ACCOUNT CLERK III
UTILIZATION REVIEW DEPARTMENT SHARON GOLDSMITH - ACCOUNT .CL.ERK III
MEDICAL RECORDS DEPARTMENT SOCIAL SERVICES - REGARDING ERRORS ON FISCHE OR
MC177
9. Do you .deal with extraordinarily difficult, angry or potentially explosive persons?
Provide an example and indicate the frequency of these contacts and what your respons-
ibility is in these situations. I AM CONTACTED BY PATIENTS BY PHONE CALLS AND BY MAIL.
MANY PATIENTS ARE IRATE AND COMPLAINING ABOUT THEIR BILLS OR ABOUT INSURANCE COVERAGE
THAT HAD NOT BEEN BILLED. I TRY TO EXPLAIN OUR VARIOUS PROGRAMS AND BILLING PROCEDURES
TO THEM AND DIRECT THEM TO THE DEPARTMENT THAT CAN HELP THEM. IF INSURANCE INFORMATION
IS INVOLVED, I REQUEST THE PATIENT TO SEND THE, INFORMATION TO ME AND I CAN TAKE CARE
10. Cffo b67W7JVdu been in your current position?
Years Months
11 . Where were you assigned before this position? Desk, Department, Location,
Assignment.
ARK - EXPERIENCED LEVEL PATIENT ACCOUNTING 606 FERRY STREET
PRESORT UNIT
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(Signature) ,, (Date)
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' CONTRA COSTA COUNTY
CLASSIFICATION QUESTIONNAIRE ,
NAME DEPARTMENT DIVISION
OFFICIAL JOB CLASSIFICATION WORKING JOB TITLE PICLV o! Work anc A►►:pneo Mojfs
Tam* R9puarsd D&scnpt,on of %...k:
Financial classes are changed after the final billing on the computer. When
I receive new billing information for Medicare, Medi-Cal or Insurance after
�" D the bill has final billed on the computer, the financial class must be
changed. Revenue must be moved and a rebill requested and necessary
documentation requested from Medical Records or Utilization Review.
If the previous financial class was one that automatically wrote off, I
reinstate the Patcom on AR, request write off reinstated and follow the
above procedures to get an accurate bill. Sometimes the new billing
information is incomplete and we must spend time verifying the information
with the various resources at our disposal.
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CONTRA COSTA COUNTY
CLASSIFICATION QUESTIONNAI RE ,
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NAME DEPARTMENT DIVISION
OFFICIAL JOB CLASSIFICATION WORKING JOB TITLE Plc.. o: Wo(k one Ass:pn.c Mo.r_
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Tam• Requared D.acnpl,un of Wo,k:
I also must call a patient's worker when I have received conflicting
information from the patient's folder, the CDS fische or Cal Meds. .
When I notice that a patient has a odd aid code 'in his or her Medi-Cal
number I know that I must have a share of cost form (MC177) . This
form should be in the patient's folder upon receipt by the Transfer Unit
If it is not in the folder, a phone call is made to the patient requesti
that they send the form to us. If patient states that the form is lost,
I check worker's name and call Social Service Department for patient's
amount of share of cost. I check to see if patient's total bill exceeds
the share of cost. If the share of cost is not met, the patient is
responsible for the bill. If the share of cost is met, I notify the
Social Service Department with an MC177 manually completed,by me,
requesting labels. I should receive the labels within 4 to 6 weeks.
The statement is checked for correct charges. Any surgical procedures
need an RVS code for billing purposes. I find the codes from a code
book and write them on the statement for the biller to see. Any other
necessary forms need to be requested at this time.
If a male baby has been circumcised, the parents must receive a bill for
the costs of circumcision. A financial class change must be done by me
at this time for data mailer purposes.
If a folder has the needed Medi-Cal label, the statement, the TAR and
all information is correct - I then give it to the Account Clerk III
with the direction to bill, combine or make any other necessary adjustmei
If any necessary fbrm is missing, I keep the folder until complete.
Insurance - In order for the biller to bill insurance a signed face
sheet or a Consent for Disclosure of Information is needed. If the
Consent was not signed by the patient at the hospital, I send the form
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to the patient requesting signature. The name and address of the
insurance company involved must be correct. I call insurance companies
to verify conflicting information. I check the statement and if all
necessary information is in the folder and all charges are correct I
give it to the Account Clerk III with directions to bill. If it is
incomplete, I hold it.
Health Plan - Interdepartmental - The charges must be checked on the
statement. I check the CRT to verify that the amaunt has been written
3 E✓ off. If not written off I determine the amount tD be written off and
direct the Account Clerk III to do write off. I also direct the origina
copies •of the statements to the correct departments. The folder is then
filed.
Private Pay - Contract - These two financial clay-:es were set up for
people who have no medical insurance. In each ca;)Ie the patient is sent
�6 a copy of the bill and requested by me to begin piyments. A contract
person already has scheduled payments set with a person in the
collections department.
I also attend two meetings a month with Financial!Counselors. At these
meetings we discuss current problems with present;.3rocedures used in
1�0 preparing the inpatient data for billers. I help to develop new
procedures to efficiently gather accurate financial information for
current billing.
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- CONTRA COSTA COUNTY
CLASSIFICATION QUESTIONNAIRE
Jeanette Lopez ` Health Rprmirjact Patient A.r•rrnnnti
NAME DEPARTMENT OIVI 10'N r'nw
OFFICIAL JOB CLASSIFICATION WORKING JOB TITLE place of War► ono Assigner Mo.:ri
Time RsQuired Description of Work:
I receive 'Inpatient folders from the hospital generally 3 to 30 days after
the date of discharge. The folders are checked off on a report sheet and
E ;D divided alphabetically. Once .the folders are checked in I begin checking
tit for accuracy of financial classes assigned patient's by Financial Counselors.
' Any folder marked referred to Hayt, Hayt and Landau is verified by the
referral inside and set aside for HH&L to work on.
I receive Inpatient statements on a daily basis with the itemization of the
services and supplies rendered to the patient. All statements are matched
with the folders sent from the hospital. At this time the financial classes
on the statements are checked with the financial classes in the folders. Not
t(1 all information given to me in the folder by the Financial Counselors is
accurate or consistent and I check on the CRT, CDS fische and other resources
to get corrected information and notify Utilization Review Department by
a phone call and in writing of financial class change. If I have an
Inpatient folder with necessary documentation and a statement is not received
within 3 to 5 days, I use the CRT to investigate what is holding up the
statements If only insurance verification is needed, I then verify the
insurance information and a statement should drop from the system within days.
The various types of financial classes that I work with are: 7
Mental Health - Medi-Cal - I check the folder for current label. If
there is no label, check outpatient folders, make phone call to patient
requesting labels or an AB1305 can be filled out and sent to Social
Service Department requesting labels. The CRT needs to be used to see
if current charges have been written off. File folder in purged.
Mental Health - Short Doyle - I check for active date of Short Doyle and
for patient's annual liability if any. Change financial class so
patient may receive- data mailer for liability. I then check the CRT
to verify that all but the patient's liability has been written off. If
it has not been written off, I write the amount of write off on a write
sheet and direct the Account Clerk III to do the necessary procedure.
The folder is filed.
M - Medicare with all other secondary financial classes - Ecample:
MO - Medicare Only - MI - Medicare and Insurance - I check to verify
Medicare eligibility, I also check for a DRG which lists a diagnosis
1 and procedures performed. I must have Medi-Cal labels where necessary,
G a signed face sheet or a Consent for Disclosure of Information signed
by the patient with correct name and address of insurance coapa:iy involve
If any surgery was performed on the patient, I need to call Surgery Dept.
for exact anesthesia time and write it on the statement. Any surgical
procedure:performed must have an RVS code for the procedure pe�,_formed.
I check that procedures listed on the DRG are charged. If all itecessary
information is in the folder, I then direct the Account Clerk III to bill
T - Medi-Cal - The first item I check, is if it is mother and hab Mothe
and baby inpatient stays do not require a Treatment Authorizatior Request
if the stay is 3 days or less. I also must check to see if it wa! an
ABC delivery or a normal delivery, also if the baby was scale or fe.nale.
Anything over 3 days requires a TAR. After checking for a TAR I m st
have a Medi-Cal label. If no label is in the folder, I check the l. �tient
outpatient folders, .call the patient and request a label for date o.
service, check the CDS fische to make sure patient was eligible to
Medi-Cal, call the Social Service Department and speak to patients Mn rker
(worker number obtained from CDS fische) or complete an AB 1305
requesting labels from Social Service Department.
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