Health Care Billing Clerk II (1636) - Dept. of Public Health - (H00153)

The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status. 

• Application Opening – Friday, June 25, 2025
• Application Deadline – Application filing will close on or after Friday, July 11, 2025, and will close any time thereafter.
• Salary: $85,124 - $103,428 Annually
• Appointment Type: Permanent Civil Service
• Recruitment ID: CBT-1636- H00153

The Mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. SFDPH strives to achieve its mission through the work of two main Divisions - the San Francisco Health Network and Population Health. The San Francisco Health Network is the City’s only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers.

The eligible list resulting from this recruitment may be utilized to fill future and current vacancies in this class at other locations within the DPH for the duration of the eligible list. 

Under general supervision, the 1636 Health Care Billing Clerk II processes difficult and complex medical claims to Medicare, Medi-Cal, Commercial and third-party payers for services provided to patients by the Departments of Public Health. This classification is the journey-level class in the series responsible for performing the full range of duties.

The 1636 Health Care Billing Clerk II performs the following essential job functions:

• Processes bills and claims for services rendered to patients in order to obtain reimbursement from Medicare, Medi-Cal, commercial, and third-party payors based upon current governmental billing rules and regulations;
• Evaluates billing documents and claims data for accuracy, completeness, and program compliance;
• Prepares the initial claims and the follow-up claim if necessary by categorizing charges according to the types of medical services provided, completing medical information, verifying that all charges relate to the diagnosis and calculating the charges and benefits according to regulations;
• Spends down Medi-Cal share of cost in order to certify monthly coverage to allow processing of claims;
• Posts payments received from various payors, including Medicare, Medi-Cal, commercial, and third-party payors;
• Sends Claims Inquiry Forms (CIFs), appeals, and tracers on unpaid accounts at predetermined intervals;
• Researches questions and denials and provides assistance to patients, physicians, insurance and legal representatives, fiscal intermediaries and other regarding claims reimbursement and coverage;
• Produces reports relevant to billing and claims activities using electronic databases.

The 1636 Health Care Billing Clerk II also performs other related duties as required.

Minimum Qualifications - Required

EXPERIENCE: One (1) year of experience billing, claims processing and/or collecting healthcare services reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third party payors, and individual payors in a hospital, healthcare agency, or healthcare billing organization.

Substitution: Completion of 15 semester units or 22 quarter units of medical billing related coursework from an accredited college or university may substitute for six (6) months of qualifying experience.

Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.

One-year fulltime employment is equivalent to 2,000 hours (2,000 hours of qualifying work experience is based on a 40-hour work week).

Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities.

Selection Procedures: 
After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following.

Assessment Component
Candidates that meet the minimum qualifications will be invited to participate in written multiple-choice exam that is designed to measure the knowledge, skills, and abilities in job related areas which may include but not be limited to:

• Knowledge of medical claim data collection, billing, and processing for reimbursement from Medicare, Medi-Cal, commercial, and third-party payers
• Knowledge of basic medical terminology
• Knowledge modern office practices and procedures 
• Knowledge of payment posting procedures
• Ability to perform detailed clerical work in a methodical and thorough manner with accuracy
• Ability to read and analyze a medical chart. Ability to read and understand information and ideas presented in writing
• Interpersonal relations ability
• Ability to perform mathematical calculations accurately and effectively
• Ability to use a personal computer to enter and update data, create documents, and use system applications, email, spreadsheets, and word-processing software
• Knowledge of Medicare and Medi-Cal rules and regulations, including Short-Doyle Medi-Cal system

Written Examination (Weight: 100%): Candidates must achieve a passing score on the written multiple-choice exam in order to continue in the selection process and will be placed on the confidential eligible list in rank order according to their final score.

Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

NOTE: Qualified applicants will receive an email notifying them of the examination's exact time and location. If you also apply and meet the minimum qualifications for the 1635 Health Care Billing Clerk I recruitment, you will only be scheduled for the examination once. Your score will then be applied to both recruitments.

Certification
The certification rule for the eligible list resulting from this examination will be the Rule of Ten Scores.

Eligible List/Score Report:
Once you pass the exam, you will be placed onto an eligible list and given a score and a rank. For more information, visit https://careers.sf.gov/knowledge/process/

The duration of the eligible list resulting from this examination process will be 12 months and may be extended with the approval of the Human Resources Director.

How to apply:
Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process. 

Our e-mail communications may come from more than one department so please make sure your email is set to accept messages from all of us at this link. 

Applicants may be contacted by email about this recruitment; therefore, it is their responsibility to contact the Analyst if they update their email address. 

Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received.

Terms of Announcement and Appeal Rights:
Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state, or local laws, rules or regulations. [Note: The correction of clerical errors in an announcement may be posted on the Department of Human Resources website at https://careers.sf.gov/. The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S Van Ness Avenue, 4th Floor, San Francisco, CA 94103-5413 by close of business on the 5th business day following the issuance date of this examination announcement. Information concerning other Civil Service Commission Rules involving announcements, applications and examination policies, including applicant appeal rights, can be found on the Civil Service Commission website at http://sfgov.org/civilservice/rules.  

Additional information regarding Employment with the City and County of San Francisco: 

• Information about the Hiring Process 
• Conviction History 
• Employee Benefits Overview 
• Equal Employment Opportunity 
• Disaster Service Workers
• Reasonable Accommodation
• Right to Work
• Copies of Application Documents
• Diversity Statement
• Veterans Preference
• Seniority Credit in Promotional Exams

If you have any questions regarding this recruitment or application process, please contact the analyst, Herbert Chau at [email protected] or (628) 271-6707. 

We may use text messaging to communicate with you on the phone number provided in your application. The first message will ask you to opt in to text messaging.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.