Benefits and Eligibility Representative
Company: Commonwealth of Massachusetts: Executive Office of
Posted on: January 18, 2023
Description MASSHEALTH Operations (MHO) is seeking a dynamic
customer service-focused professional for the role of Benefits and
Eligibility Representative. The selected candidate will work in a
productive, fast-paced call center environment, utilizing
technology and client management software to review, evaluate and
determine applicant eligibility for medical assistance in
accordance with MassHealth policy and procedures. Ideal candidates
will display exceptional customer service and demonstrate an
ability to successfully navigate a direct client-contact
Duties and Responsibilities (these duties are a general summary and
not all inclusive):
* Interview those requesting benefits; help them complete
eligibility forms and submit required verifications in order to
obtain and validate demographic and financial information.
* Evaluate submitted documents from those individuals under age 65
living in the community to insure accuracy and completeness and to
support the initial and continued determination of eligibility for
programs administered by MassHealth Operations (MHO).
* Contact applicants to obtain information not listed on
eligibility forms, contact collateral sources of information, and
determine immigrant status.
* Review electronic documents, updated demographic, financial, and
background data for member eligibility updates and make necessary
* Reconcile MHO case information with information from other
agencies and sources to verify continued eligibility for
* Respond to member inquiries and provide information regarding
* Explain appeal rights, eligibility rules, and procedures to
customers, applicants, attorneys, advocates, providers, public
officials, external agencies, the public or other parties.
* Represent agency at hearings by preparing and delivering
explanations of eligibility determinations
- Detail-oriented and highly organized, with strong ability to
successfully multi-task; Capacity to navigate a computer while on
- Stellar "soft skills" in verbal /written communication and
customer service with proven capability to identify and solve
- Skilled in active listening, while demonstrating the ability to
listen to what people say and ask questions when appropriate.
- Ability to display sound judgement coupled with maintaining
composure in difficult situations.
- Strong attention to detail with the ability to evaluate and
verify information against a set of standards.
- Proficient usage of Microsoft Office products including
Outlook, Word, and Excel.
Please upload both Resume and Cover Letter for this position when
applying. First consideration will be given to those applicants
that apply within the first 14 days.
MassHealth, the Commonwealth's Medicaid program, provides health
care benefits to certain low and medium-income Massachusetts
residents. As an innovative national leader, the Commonwealth's
Medicaid program offers the opportunity to work with
state-of-the-art technologies in a cutting-edge, fast-paced, call
center environment. Selected applicants will have exceptional
customer service, communications, and analytical skills. We offer a
unique opportunity to serve, and to make a positive contribution to
The mission of MassHealth is to improve the health outcomes of our
diverse members, their families and their communities by providing
access to integrated health care services that sustainably promote
health, well-being, independence and quality of life.
For more information about our agency and programs please visit:
A criminal background check will be completed on the recommended
candidate as required by the regulations set forth by the Executive
Office of Health and Human Services prior to the candidate being
hired. For more information, please visit
Education, licensure and certifications will be verified in
accordance with the Human Resources Division's Hiring
Education and license/certification information provided by the
selected candidate(s) is subject to the Massachusetts Public
Records Law and may be published on the Commonwealth's website.
If you require assistance with the application/interview process
and would like to request an ADA accommodation, please click on the
link and complete the Reasonable Accommodation Online Request
For questions, please the contact the Office of Human Resources at
1-800-510-4122 and select option #2.
Qualifications First consideration will be given to those
applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS: At least two years of full-time, or
equivalent part-time, professional or paraprofessional experience
in social work or social casework, claims adjudication, job
placement, recruitment, employment counseling, vocational or
rehabilitation counseling, credit investigation, educational
counseling, legal advocacy, or legal counseling.
- A Bachelor's or higher degree may be substituted for the required
experience on the basis of two years of education for one year of
- One year of education equals 30 semester hours. Education toward
a degree will be prorated on the basis of the proportion of the
requirements actually completed.
LICENSES: Based on assignment, travel may be required. Those
employees who elect to use a motor vehicle for travel must have a
current and valid Massachusetts Class D Motor Vehicle Operator's
license or the equivalent from another state.
When you embark on a career with the Commonwealth, you are offered
an outstanding suite of employee benefits that add to the overall
value of your compensation package. We take pride in providing a
work experience that supports you, your loved ones, and your
Want the specifics? Explore our Employee Benefits and Rewards!
Executive Order #595: As a condition of employment, successful
applicants will be required to have received COVID-19 vaccination
or an approved exemption as of their start date. Details relating
to demonstrating compliance with this requirement will be provided
to applicants selected for employment. Applicants who receive an
offer of employment who can provide documentation that the vaccine
is medically contraindicated or who object to vaccination due to a
sincerely held religious belief may make a request for
An Equal Opportunity / Affirmative Action Employer. Females,
minorities, veterans, and persons with disabilities are strongly
encouraged to apply.
The Commonwealth is an Equal Opportunity Employer and does not
discriminate on the basis of race, religion, color, sex, gender
identity or expression, sexual orientation, age, disability,
national origin, veteran status, or any other basis covered by
appropriate law. Research suggests that qualified women, Black,
Indigenous, and Persons of Color (BIPOC) may self-select out of
opportunities if they don't meet 100% of the job requirements. We
encourage individuals who believe they have the skills necessary to
thrive to apply for this role.
Official Title: Ben Elig & Refer Soc Wrk (A/B)Primary Location:
United States-Massachusetts-Quincy - 100 Hancock StreetJob:
Community and Social ServicesAgency: Exec Office Of Health and
Human ServicesSchedule: Full-timeShift: DayJob Posting: Jan 4,
2023, 6:12:56 PMSalary: 55,036.54 - 74,951.50 YearlyIf you have
Diversity, Affirmative Action or Equal Employment Opportunity
questions or need a Reasonable Accommodation, please contact
Diversity Officer / ADA Coordinator: Johny Laine
(Johny.Laine@mass.gov) - 6173485067Bargaining Unit: 08-SEIU - Local
509 - Social/RehabilitationHybrid Work Eligible: No
Keywords: Commonwealth of Massachusetts: Executive Office of, Taunton , Benefits and Eligibility Representative, Other , Taunton, Massachusetts
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