Benefit Eligibility & Referral Social Worker

Commonwealth of Massachusetts; Tewksbury Junction (MA); On-site; USD 66,000 - 90,000; Full time

Job summary

The Massachusetts Department of Public Health seeks a Benefits Eligibility & Referral Social Worker at the Tewksbury Hospital campus to assist patients with public benefit programs, care coordination, and financial planning. The role emphasizes advocacy, accuracy, and collaboration with interdisciplinary teams.

Responsibilities include counseling on insurance options, assisting with MassHealth and SSI/SSDI processes, and maintaining timely records to ensure seamless access to benefits and

Qualifications

• Two years of professional or paraprofessional social work or related experience.
• Bachelor's degree may substitute for two years of experience.
• Valid Massachusetts Class D driver's license or equivalent may be required.

Responsibilities

• Provides individualized financial counseling to patients, families, and responsible parties to explain insurance options and available financial assistance programs.
• Conducts private-pay assessments using the hospital sliding fee scale and documents findings in medical records and billing systems.
• Completes patient registration with accurate demographics, contact information, and insurance details.
• Assists residents with MassHealth LTC applications, ensuring sections are complete and accurate.
• Educates patients and surrogates about SSI and SSDI eligibility processes and timelines.
• Maintains spreadsheets/logs to track MassHealth eligibility, applications, deadlines, redeterminations, and SC-1 submissions.
• Helps patients with paper/electronic USCIS applications related to immigration status and work authorization.
• Reviews PNA balances and generates PNA reports to identify assets exceeding limits.
• Tracks SORB-related requirements and annual fee obligations for designated patients.
• Completes DPPC reports in collaboration with clinical teams and mandated reporting standards.

Skills

Report writing

Interviewing

Data gathering

Communication

Record keeping

Arithmetic

Education

Bachelor's degree acceptable substitution

Tools

MMIS

Virtual Gateway

Meditech

Job description

An Official website of the Commonwealth of Massachusetts

Job Description - Benefit Eligibility & Referral Social Worker (260006OO)

Job Description

Benefit Eligibility & Referral Social Worker - ( 260006OO )

Description

The Massachusetts Department of Public Health (DPH) at Tewksbury Hospital is accepting applications for a Benefits Eligibility & Referral Social Worker (A/B).In this role, you will serve as a trusted resource for patients, families, guardians, and interdisciplinary care teams, ensuring individuals have access to the benefits, financial assistance, and community resources they need to support their health, recovery, and successful transition of care. This position is ideal for professionals who are passionate about advocacy, problem-solving, and improving access to essential services while working in a mission-driven healthcare environment.

As part of the Department of Public Health, you will join a dedicated team committed to providing compassionate, patient-centered care while developing expertise in MassHealth, Social Security, disability benefits, long-term care eligibility, and care coordination. This role offers the opportunity to build strong relationships with patients and community partners, expand knowledge of public benefit programs and healthcare systems, and contribute to meaningful outcomes that improve financial stability, continuity of care, and overall quality of life for some of the Commonwealth’s most vulnerable populations.

Please note: The schedule for this position is Monday – Friday, 8:00am – 4:00pm.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

• Provides individualized financial counseling to patients, families, and responsible parties to explain insurance options, out-of-pocket responsibilities, and available financial assistance programs.
• Conducts private ‑ pay assessments using the hospital sliding fee scale, documenting findings and recommendations clearly in the medical record and billing systems.
• Completes patient registration for new and returning patients, ensuring accurate entry of demographics, contact information, emergency contacts, and insurance details.
• Assists residents, families, and responsible parties with completion of MassHealth LTC applications, ensuring that all required sections are filled out accurately and completely.
• Educates patients and surrogates about SSI and SSDI eligibility criteria, application processes, and timelines.
• Maintains up ‑ to ‑ date spreadsheets, logs, or databases tracking MassHealth eligibility, applications in progress, key deadlines, redeterminations, and SC ‑ 1 submissions.
• Assists patients and families in completing paper and electronic USCIS applications related to immigration status, work authorization, and residency.
• Reviews Personal Needs Accounts (PNA) balances and prepares PNA reports to identify patients whose assets exceed allowable limits.
• Tracks SORB ‑ related requirements for designated patients, including annual fee obligations and reporting deadlines.
• Completes Disabled Person Protection Commission (DPPC) reports as required, in collaboration with clinical teams and according to mandated reporting standards.

Required Qualifications:

• Knowledge of the methods of general report writing.
• Ability to read, interpret, apply and explain the provisions of the laws, rules, regulations, policies, procedures, specifications. standards and guidelines governing assigned area.
• Ability to gather information through questioning and by examining records and documents.
• Ability to conduct interviews
• Ability to accurately record information provided orally.
• Ability to communicate effectively, both orally and in writing
• Ability to write concisely, to express thoughts clearly and to develop ideas in logical sequence.
• Ability to maintain accurate records.
• Ability to perform arithmetic computations with speed and accuracy.
• Ability to assemble items of information in accordance with established procedures.

Preferred Qualifications:

• Experience assisting individuals with MassHealth, Medicaid, Medicare, Social Security, SSI, SSDI, or other public benefit programs.
• Knowledge of healthcare eligibility, insurance verification, or financial counseling in a hospital, long-term care, or human services setting.
• Experience coordinating services with interdisciplinary healthcare teams and community partners.
• Strong understanding of patient advocacy, discharge planning, and care coordination principles.
• Experience preparing and managing complex applications, documentation, and case records with a high degree of accuracy.
• Familiarity with electronic medical records, eligibility systems, or case management software such as MMIS, Virtual Gateway, or Meditech.
• Excellent communication and interpersonal skills with the ability to support individuals and families during challenging situations.
• Strong organizational skills with the ability to manage multiple priorities, deadlines, and confidential information.
• Bilingual or multilingual communication skills that support diverse patient populations.
• Certified Application Counselor (CAC) credential or the ability to obtain certification after hire.

About the Department of Public Health:

The mission of the Massachusetts Department of Public Health (DPH) is to prevent illness, injury, and premature death, to assure access to high quality public health and health care services, and to promote wellness and health equity for all people in the Commonwealth.

We envision a Commonwealth in which all people enjoy optimal health. Massachusetts ranks among the healthiest states according to comparative analyses, but we face numerous challenges, including chronic and infectious disease, substance abuse, violence, preventable hospitalizations, and health disparities.

DPH coordinates programs and policies to address specific diseases and conditions and offer services to address the needs of vulnerable populations. We also develop, implement, promote, and enforce regulations and policies to assure that the conditions under which people live are most conducive to health and enable people to make healthy choices for themselves and their families. We license health professionals, healthcare facilities and a variety of businesses that impact public health. We operate the state laboratory and four public health hospitals. We monitor health status and manage vital records including births, marriages and deaths. We educate people about public health issues and work closely with local boards of health and community partners to identify and solve public health problems.

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 http://www.mass.gov/hhs/cori

Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines

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.

For questions regarding this requisition, please contact Executive Office of Health and Human Services, Human Resources at 1-800- 510-4122 Ext. # 4.

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.

SUBSTITUTIONS

• 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 experience.
• 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.

Salary placement is determined by a combination of factors, including the candidate’s years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division’s Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.

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 future.

Title 101 CMR 23.00 (“Regulation”) requires certain agency staff to have received the COVID-19 vaccination and Influenza vaccination, or have taken required mitigation measures, to prevent viral infection and transmission in State Hospitals and State Congregate Care Facilities. The Regulation applies to this position. Successful candidates will be required to acknowledge and attest to your vaccination status for both COVID-19 and Influenza.

An Equal Opportunity / AffIdinative 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-Tewksbury-365 East Street

Job

Community and Social Services

Agency

Department of Public Health

Schedule

Full-time

Shift

Day

Job Posting

Oct 7, 2026, 6:27:37 PM

Number of Openings

2

Salary

66,367.60 - 90,382.76 Yearly

If you have Diversity, affirmative action or Equal Employment Opportunity questions or need a Reasonable Accommodation, please contact Diversity Officer / ADA Coordinator : Sandra Semedo: [e-mail] - 6173524250

Bargaining Unit : 08-SEIU - Local 509 - Social/Rehabilitation

Confidential : No

Potentially Eligible for a Hybrid Work Schedule : No