Benefits & Eligibility Specialist

Mass; Chelsea (MA); On-site; USD 66,000 - 90,000; Full time

Benefits offered by this job

Hybrid work schedule

Job summary

MassHealth Operations (MHO) is seeking a Benefits and Eligibility Representative to work in a fast-paced call center environment, reviewing and determining eligibility for medical assistance in accordance with MassHealth policy.

The role requires interviewing applicants, collecting verifications, and communicating eligibility decisions. The selected candidate will initially report in person five days a week in Chelsea, MA, with a possible hybrid arrangement after nine months.

Qualifications

• At least two years of similar experience in social work or related fields.

Responsibilities

• Interview applicants to complete eligibility forms and gather verifications.
• Evaluate documents to determine initial and continued eligibility for MassHealth programs.
• Contact applicants and collateral sources to verify information, including immigrant status.
• Review updated demographic and financial data for eligibility updates.
• Explain eligibility rules and appeal rights to customers and other parties.
• Represent the agency at hearings with explanations of determinations.
• Report to the office in-person five days per week for nine months; hybrid option may be considered afterward.

Skills

Active listening

Information ordering

Comprehension

Expression

Written comprehension

Written expression

Evaluating information against...

Problem identification

Adaptability & flexibility

Attention to detail

Education

Bachelor's degree

Tools

Microsoft Office (Outlook, Word, Excel)

Job description

MassHealth Operations (MHO) is seeking a Benefits and Eligibility Representative to work in a fast-paced call center environment, reviewing and determining eligibility for medical assistance in accordance with MassHealth policy.

The role requires interviewing applicants, collecting verifications, and communicating eligibility decisions. The selected candidate will initially report in person five days a week in Chelsea, MA, with a possible hybrid arrangement after nine months.