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Job Description
This recruitment will establish an employment list to fill current and any future vacancies within the Health & Human Services Agency. The anticipated life of the employment list is six months. If interested in employment for this position for current or future vacancies, please submit an online application for consideration.
Current vacancy is with the Children's Medical Services Department of the Public Health branch located in Tulare. The anticipated life of the list is six months.
Typical Duties
Plan, assign, train, supervise and evaluate the Children Services Workers and other direct report support staff; participate in the development and preparation of California Children’s Services (CCS) budget, goals and objectives consistent with organization's goals; coordinate the needs of the unit's information system; assist management in completing claims related special projects; prepare reports on CCS case activities and statistics for review and evaluation by management and utilization review staff; provide instruction on Medi-Cal, Other Target Low Income Children Program (OTLICP), Medi-Cal Eligibility Data System (MEDS), and the CMS program system; provide instruction on CCS policies and procedures; provide technical assistance on patient classification and eligibility issues; prepare reports and charts on Medi-Cal, OTLICP and CCS-only cases; review client files for proper enrollment documentation related to financial eligibility and third party payor(s); monitor clients with a Medi-Cal share of cost to determine potential savings; monitor and maintain an effective and efficient case filing system to allow easy retrieval of case files; assist the Patient Accounts Representative in activities involving the processing, auditing and payment of claims for CCS clients; review non Medi-Cal cases for correct eligibility information to see if they can become Medi-Cal or OTLICP eligible; complete the CCS annual performance measures report; collect, compile, and analyze claim data; act as a resource on claims issues; review and analyze client cases to ensure quality of performance and compliance with CCS policies and procedures; answer inquiries concerning CCS client matters; interpret and explain laws and regulations; ensure compliance with standards and regulations; maintain records on all assessment and enrollment fees collected; assist with community outreach CCS events; attend and participate in staff meetings. Essential job duties may be assigned that are not listed above but are relative to this job classification. (Reasonable accommodation will be made when requested and determined by the County to be appropriate under applicable law.)
Minimum Qualifications
Minimum qualifications are used as a guide for establishing the education, training, experience, special skills and/or license which are required and equivalent to the following.
Education: Equivalent to completion of 48 units of college level study in health sciences, social sciences or closely related field.
Equivalency for Education: Direct and specific program experience may be substituted for the educational requirement on a ratio of one (1) year of direct/specific experience for one (1) year of college education.
Experience: Two (2) years of increasingly responsible and complex technical experience. Work experience must demonstrate making independent decisions.
Knowledge of: Financial record keeping procedures; math sufficient to calculate financial eligibility, compile data and compute percentage; California Children's Services (CCS) program guidelines, rules and regulations; principles and practices of supervision, evaluation and training; Medi-Cal, Medicare, and private insurance regulations and billing practices; medical diagnosis and procedural coding systems; laws and regulations governing collection procedures; interviewing techniques to obtain or exchange information; proper communication methods and practices for all forms of communication; standard office practices, methods, equipment, and procedures. Correct use of punctuation and grammar in all forms of communications; patient accounting practices; basic medical terminology.
Skill/Ability to: Work and communicate effectively with people of various education and socioeconomic backgrounds by respecting beliefs, interpersonal styles and behaviors of both clients and co-workers; operate contemporary office equipment inclusive of computer, keyboard, and all applicable electronic equipment. Develop and implement policies and procedures relating to claims; gather, assemble, analyze, and evaluate facts, draw logical conclusions, and make appropriate recommendations; prepare statistical reports using correct grammar, punctuation, and spelling; interview patients and others to obtain financial and personal information; evaluate patient's financial status and plan appropriate payment agreements; initiate and coordinate changes to software to enhance performance; maintain patient confidentiality; organize work and maintain systematic, detailed, and accurate records; retain and recall information; understand and follow oral and written instructions; maintain productivity with frequent interruptions; be a patient and sympathetic listener when working with those under stress or experiencing major life trauma; effectively work independently and in a team oriented environment.
Additional Information
Conditions of Employment
Candidates selected will be required to pass a pre-employment drug and alcohol screening. Additionally, a background investigation may also be conducted, which may include a re-investigation every 10 years for some positions. An Employment Eligibility Verification using E-Verify may be required on the first day of employment for some positions. Some job classes may also require a physical exam.
College Cost Reduction Access Act
This may be a qualifying position for student loan forgiveness through the College Cost Reduction and Access Act (CCRAA). Only student loan payments made after October 1, 2007 and in a qualified repayment plan are eligible. For more information you are encouraged to speak with your student loan servicer or visit: https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service
EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER
Bargaining Unit 7
The information listed is a general summary of benefits. These provisions do not constitute an expressed or implied contract and are subject to change.
Benefit Amount: An annual benefit amount is provided and may be applied towards health insurance premiums (medical, dental, vision and life). This benefit is pro-rated and paid on a pay period basis (24 pay periods).
Health Insurance: A choice of PPO and HMO medical plans which include PPO and HMO dental plans and include dental and vision coverage. Dependent coverage is available. Providers include Anthem Blue Cross, Kaiser Permanente, Delta Dental, and Vision Services Plan (VSP).
Retirement: The retirement plan is a defined benefit plan administered pursuant to the 1937 Act County Employees Retirement Act and integrated with Social Security. In addition to ordinary retirement benefits, the plan provides disability and death benefits. Retirement contributions are made by both the County and the employee. The County has reciprocity with the State of California, contracting PERS agencies, and all County 1937 Act Retirement Systems.
Paid Holiday Leave: 12 set days and 1 personal holiday.
Vacation Accrual:
2 weeks per year (0-3 years of service)
3 weeks per year (3-7 years of service)
4 weeks per year (7-11 years of service)
5 weeks per year (11+ years of service)
Limit of 300 hours.
FLSA exempt employees accrue an additional 5 days of vacation per year.
Sick Leave Accrual: 12 days per year with unlimited accumulation, 60 hours of which may be used toward family sick leave.
Group Term Life Insurance and AD&D: $10,000; Provided by Standard Insurance Company.
Disability Insurance: Employees are covered by State Disability Insurance. The premium is paid by the employee.
Deferred Compensation: A voluntary deferred compensation plan is available.
To view more detailed descriptions of Tulare County's benefits, please view the Benefits section of our Web site at https://tularecounty.ca.gov/hrd/benefits-wellness/health-plans-active-employees/
The Provisions Of This Bulletin Do Not Constitute An Expressed Or Implied Contract And Are Subject To Change.
Closing Date/Time: 5/17/2025 11:59 PM Pacific -
ABOUT THE COMPANY
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County of Tulare - HR&D
Show moreThe mission of Tulare County Human Resources and Development is to attract, retain, and develop a highly skilled workforce. We provide a wide array of services to our department and agencies including training, payroll processing, employee/labor relations, employee records, wellness programs, and benefits administration. Our dedicated staff supports 20 County Departments and over 5,100 employees in more than 800 job classifications.
Tulare County employees enjoy generous benefits, including a choice of excellent health plans, vacation, paid time off and retirement packages. Working for Tulare County is like working with family. You are encouraged, supported and given flexibility to balance your work life and your private life. You'll have an opportunity to begin or enhance a meaningful career where what you do matters.
To view jobs specific to the Health and Human Services Agency click here.
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