PATIENT RELATIONS REPRESENTATIVE

Patient Relations RepresentativeLA Health Services is LA County's integrated healthcare system and the second-largest public health system in the nation. Our system includes four public hospitals, more than 20 community health centers, Emergency Medical Services (EMS), Correctional Health Services, and community-based programs that connect people to care where they are.We serve as the safety net for more than 10 million residents, providing care regardless of ability to pay, insurance coverage, or immigration status. As one connected system, we deliver extraordinary care—from prevention and primary care to emergency, specialty, trauma, and recovery services across Los Angeles County.With more than 2.9 million visits annually and a workforce of over 23,000 dedicated staff, LA Health Services is proud to deliver high-quality, compassionate, and accessible care to everyone, no matter how they come through our doors.Explore our one system of hospitals and community health centers: Our Locations – Health Services Los Angeles County.Mission: To advance the health of our patients and our communities by providing extraordinary care.Check Out Our Outstanding Benefits!We offer one of the strongest public-sector benefits packages in the country. Join us and discover a rich selection of health care options, robust retirement plans and the flexibility to work, relax and rejuvenate as you reach your fullest personal and professional potential. Click here to see comprehensive information regarding County employee benefits.What does a Patient Relations Representative do:Performs complex and specialized patient access and patient relations functions and leads lower-level patient resources workers.Assesses and resolves complex patient issues related to primary care linkage, eligibility, billing for services, and managed care plan assignment. Research 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.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.Research grievances with hospital administration, physicians, nurses, and other patient support staff; refers inquiries to appropriate department or clinic for response.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.Assigns, coordinates, and reviews the work of lower-lever personnel in the unit, ensuring proper work methods are followed. Provides technical assistance and training.Answers and documents incoming calls from patients or providers or greet walk-in members who have concerns surrounding medical care issues.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.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 obtain signatures and collects and keep records of insurance and patient identification.Manage/build provider and clinic templates -Design Change Worksheets (specialized work) working alongside clinicians and Cerner to complete the request as assigned.Applies various rules and regulations of Medicare, Medicaid, Managed Care, and commercial payers regarding referrals, authorizations, and certifications.Performs general office duties, such as answering multiple lines, making appointment reminders, copying, filing, scanning, and faxing.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.Prepares daily, weekly, and monthly patient service and activity reports for management's review.Requirements to Qualify: Option I: Two (2) years of experience in the service of the County of Los Angeles as a Patient Resources Worker.Option II: Three (3) years of experience in a healthcare setting at the level of Patient Resources Worker with responsibility for performing patient access related work in Emergency Department or Urgent Care registration or other walk-in registration, including admitting, financial screening and eligibility verification, and scheduling.Withhold information: No withhold will be allowed. Required experience must be fully met at the time of filing and clearly indicated on the application.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 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.Special Requirement Information: To qualify under Option I, you must have held or hold the title of Patient Resources Worker in the services of the County of Los Angeles for at least two years. For Option II, you may still qualify even if your job title isn't exactly the same as the ones listed. What matters is that your experience is at the appropriate level — meaning your job involves similar responsibilities, requires comparable skills and knowledge, and takes place within a similar organizational structure. Please provide a clear explanation of your experience to demonstrate that it is at the appropriate level. Also, for this option, if you are a LA County employee who 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 Question sections of your 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 to assist with the review of your application.Desirable Qualifications:Additional experience beyond the qualifying option.Experience interviewing the public to initiate or complete applications for financial assistance, charity care, or insurance for medical or mental health services.Completion of thirty (30) semester units or forty-five (45) quarter units in any subject area earned in an accredited college or university.To receive credit for your education, include a legible copy of all relevant official documents, including your transcript from an accredited institution or email it to View email address on click.appcast.io within (7) days of filing your application. The document should show the number of units and the type of unit system used (e.g., semester, quarter) and be in English. If not in English, then translation is required. International degrees must be evaluated for equivalency to US standards and indicate the number of units and unit system. Documents marked as unofficial will not be accepted. For more information on our standards for educational documents, please visit: (Download PDF reader)We do not accept password-protected documents. Ensure documents are unlocked before attaching to your application or sending to the exam analyst.Additional InformationExamination Content: This examination will consist of an evaluation of experience, desirable qualifications and supplemental questionnaire and assign a score based on a standardized scoring system. This assessment is worth 100% of your total score.Candidates need to achieve a passing score of 70% or higher on the examination in order to be placed on the eligible list.Eligibility and Vacancy Information: Applicants who passed the assessment are placed on a list in the order of their score group for a period of twelve (12) months. Applications will be processed as they are received and added to the list accordingly. We will use this list to fill vacancies in LA Health Services as they occur.No person may compete in this examination more than once every twelve (12) months.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 County of Los Angeles