HomeMy WebLinkAboutMINUTES - 06101986 - 1.21 .s
POSITION ADJUSTMENT REQUEST No. l I
Date: May 15, 198
Dept. No./ Copers
Department Health Svc/CCHP Budget Unit No. 0860 Org.,.No..,§ 17 :,.Agency No. 54 _
' Action Requested: Reallocate Clerk-Experienced level position #54-1387-,to.Account Clerk -
Beginning level. V;t.
Proposed Effective Date: 6/18/86
Explain why adjustment i^ needed: To properly classify the incwbent (M. Austin) according to
the duties she performs in the Health Plan Business Office Accounts Payable section.
t
Classification Questionnaire -r*tached: Yes ® No ❑
Estimated cost of adjustment: $ 0 (same salary)
Cost is within department 's budget: Yes ® No ❑
If not within budget, use reverse side to explain how costs are to be funded.
Department must initiate necessary appropriation adjustment, web Beadle,
Use additional sheets for further explanations or comments. Dept. Personnel Officer
for Department Head
Personnel Department Recommendation
Date:
Reallocate Clerk-Experienced Level position #54-1387, 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.
6 - i 1 — Y46
Date or Director rsonneI
County Administrator Recommendation ,/ p
Date: � -7` "0 6
Approve Recommendation of Director of Personnel
Disapprove Recommendation of Director of Personnel
Other:
for County Administrator
Board of Supervisors Action JUN 10 1996 Phil Batchelor, Clerk of the Board of
Adjustment APPROVED/4i-S4PP#OM on Supervisors and County Administrator
Date: JUN 10 1986 By:
APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT,
nM-Fm
Oates
Worked: Employer; Title. Duties :
7/80-12/81 Stuart Anderson's Black Waitress 8 Greeting customers, taking
Angus Restaurant Hostess food and dri.nk orders,
3195 N. Main Street delivering meals, servicing
Pleasant Hill , CA 94523 their drinks, selling by
suggesting, totaling bills
and cash handling.
Salary: Reason for leaving:
$3.25 hr. + tips Obtained a full time job.
$4.00 hr.
Dates
Worked: Employer: Title: Duties :
1/81-5/81 Contra Costa County Student Intern Worked as an assistant to the
Area Agency on Aging Program Evaluator, mainly
2425 Bisso Lane interviewing. I did both per-
Concord, CA 94520 sonal and telephone interviews,
report writing, writing ques-
tionnaires and various clerical
Salary: duties.
Volunteer
Reason for leaving:
Internship ended.
Dates
Worked: Employer: Title: Duties:
2/80-5/80 Rape Crisis Intervention Crisis Line Worker Working on an "on call" basis
PO Box 423 for a 24 hour hotline. Assist-
Chico, CA 95926 ing people through the crisis
of rape, bodily abuse and
Salary: suicial tendencies.
Volunteer
Reason for leaving:
Moved out of the area.
Dates
Worked: Employer: Title: Duties:
7/79-12/79 Denny's Restaurant
540 Main Street Waitress General waitress duties.
Chico, CA 95926
Salary: Reason for leaving:
$2.70 hr. + tips Moved out of the area.
Ml
l `
COMMENTS OF IMMEDIATE SUPERVISOR
Do you concur or disagree with the I statements of the employee? if you disagree, be
specific as to why.
I concur.
What parts of this job do you check or review closely and ,why?
Maureen has been doing this desk for over a year now and at this
point I do not check her work closely. We have an open communication
and if she has questions or problems we discuss them as they come
She is competent and experienced on this desk and ) recommend this action.
(Date) 5/12/86
(Signature)
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) i(Date)
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1. What is the function of your work unit?
Our Accounts Payable Unit processes out-of-plan claims for the Contra Costa
Health Plan.
2. For whom or for what group are you providing clerical support?
The Health Plan Fiscal "tanager, Health Services, Conservatorship and
the ,Auditor-Controller.
3. Designate the name and title of the person who supervises your position.
How is your work reviewed?
Anna Romo--Account Clerk III , Lead Supervisor.
The Auditor-Controller's office checks my work for the proper billing information
and correct totals. They also double-check to make sure the claims have not been
paid before.
4. Where is your supervisor located in proximity to your desk?
In the same unit, approximately six feet away.
5. What are the most important assignments you perform and why?
Processing the emergency transportation claims. These 'claims represent the
majority of money I approve for payment.
6. What is the most difficult or complex work you perform and why?.
Processing the emergency transportation claims. These require knowledge of both
current and past ^edi-Cal rates; policies, and familiarity with their transportation
codes.
7. What parts of your job involve the greatest responsibility and why?.
The pricing and coding of claims. The pricing determines the amount of money we
are going to pay and the coding identifies the fund in which the money will come
from. This data needs. to be accurate to assist the Fiscal "tanager in proper
forecasting and budgeting.
8. List the name and job titles of employees to whom you are assigned to provide
lead direction.
N/A
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 responsibility is in these situations.
Occasionally I have to deal with a member who is angry because they are getting
billed or sent to collections by a provider. I have to assure them I will take
care of the problem immediatley. If they continue to receive bills, they are to
call me back. I get about two of these calls a month.
10. How long have you been in your current position? 1 5 -
Years) Months
11. Where were you assigned before this position? Desk, Department, Location,
Assignment.
Central File Room, Medical Records
Contra Costa County Hospital , ",artinez
(Signature) v f /I., ^iA tai , . (Date) _ Xla,,� /-l,/9&,
ACCOUNT CLERK CLASSIFICATION QUESTIONNAIRE (Continued)
Percent Of Description of Work:
Time Required
for payment. The demands used for emergency transports are
signed by a CCHP administrator, copies are made and sent to the
Auditor's A/P for payment. Copies are filed by vendor as "pro-
cessed" and are updated to "paid" as soon as verification of
payment is received from A/P.
Pharmacy Claims
Pharmacy claims are processed for Health Plan members only and
the amount charged is paid. Pharmacy claims comb in daily,
averaging approximately 200 a week. Processing these claims
requires about 401J of my time.
Eligibility is verified on claims using the CRT. The authori -
zation is stamped on the back of prescriptions. If the patient
was not eligible on the date of service, a denial letter is sent
to the vendor. The ""edi-Cal claim form itself must be filled
out thorougly or I will send it back requesting the necessary
information. If a claim comes in with a prescription with re-
fills, the prescription is filed in my refill file. I monitor
the refills to make sure they are not exceeded (very important) .
401�
These claims are coded with the same process as transportation
and require vendor numbers. The vendor numbers are checked on
a printout which is revised weekly. If a claims is received
from a new vendor, the information (name, address, etc. ) is en-
tered into our system and a new vendor x is issued. The charges
are totaled and when everything is correct, the claims are stamped
"approved for payment" and initialled. Copies of these claims
are maintained in this office with the prescription. The claims
are then sent to the Auditor's A/P for payment.
I also process demands to reimburse Health Plan members who have
paid for a prescription themselves. Eligibility is checked, and
a demand is sent to them for signature. Upon return of the signed
demand with a receipt, a request for a vendor number is made. The
claim is then processed as above.
Other Duties
Daily totals are kept on all incoming and outgoing claims for the
Financial Services Manager, also maintenance of current informa-
tion regarding transportation rate changes and keeping up written
procedures for this position. Daily, providers call with a list
1011 of patients and requests for verification of eligible members.
If patient is not covered under CCHP, microfiche is checked to
give provider Medi-Cal or Medicare eligibility. This process
eliminates the provider from billing CCHP for non-covered members,
it does not authorize the transport. Knowledge of contracts and
rates for services provided by vendors is also an important part
of this unit. Contact with all providers, auditors, patients and
Health Services Administrators is constant.
ACCOUNT CLERK DEEP CLASS
CLASSIFICATION QUESTIONNAIRE
'laureen Austin Health Services C.CL H alth plan 9rrnnntc r�„�hi�
Name Department Division Work Unit
Account Clerk _ _ _ _ _ 815 1"a i n Street. :Mart i nal 0.4553
Job Classification or Location & Address
Percent of Description of Work:
Time Required
"Transportation/Pharmacy Maims Clerk” workload .includes processing
emergency and non-emergency transportation claims for Health Plan
members in addition to non-emergency transportation claims for all
of Health Services. Pharmacy claims are for 'tealthlPlan members who
receive prescriptions or medical supplies outside of our facilities.
Transportation Claims
There are two types of transportation claims, emergency and non-
emergency. Emergency transport claims are for ambulance runs which
are paid by demand. Non-emergency transport claims are for taxis,
wheelchair cars, guerney cars, and ambulances with pre-authorization.
Non-emergency transport claims are payable by purchase order con-
tracts.
The first step in processing any claim is verifying Health Plan
eligibility for the date of service - using a CRT to verify the
patient' s name and noting subscriber number - using the subscriber
to verify Eligibility History and identify which Health Plan group
s/he is in. If a patient is not eligible on the date of service
the claim will be denied, if an emergency run, or charged to the
50,; requesting cost center, if a non-emergency claim. All claims are
priced out according to coverage ( i .e. , "Iedi-Cal , Medicare & Com-
mercial ) .
Runs from the Sheriff's dispatcher are maintained on numbered cards
for West and Central County. The serial numbers on these cards
act as the authorization numbers for the ambulance claims. East
County Delta Regional Communications Center record their calls in
a computer printout assigning each a call number. These call num-
bers are the authorization numbers for East County residents .
'1aintaining the file for the Sheriff cards-and-hooks-for-the D.R.C.C.
printouts are a responsibility of this. position. These cards and
printouts are checked to verify transports. When checking the
authorizations, a note is made on the card or printout to show that
a claim for that run has been processed.
Processing these claims requires knowledge of coverage for the dif-
ferent Health Plan groups, approved �lledi-cal codes and rate and
"tedicare billing procedures. Since most of the transportation
claims are paid at Medi-Cal rates and are billed at full charges, I
am required to adjust claims for Health Plan members. After these
rates are determined, an adjustment to the total on the demand or
statement will reflect payable amount.
All claims are coded with five sets of codes. Each code reflects
an activity: Org � (Service Code) ; Expense Code (reflects coverage) ;
Task Code (type of service) ; Option Code (shows how many and where) ;
and Lag Code (shows time between DOS & claim-paid date) .
After all the claims are coded, a tally is made of the codes and a
coding sheet is completed for the Auditors. Purchase orders are
used to pay non-emergency transportation, and a partial shipment
slip is completed with totals .to be paid listing all cost centers,
org #E's and total price. Copies are then made of the claims state-
ment and partial for my files and the originals are sent to Stores
January 1985