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Mass Health Benefits and Eligibility Representative in Tewksbury, Massachusetts

MassHealth is seeking dynamic customer service-focused individuals to serve as a Benefits and Eligibility Representative. The successful candidate will be responsible for assisting individuals and families (including those individuals over the age of 65 residing in a nursing facility) with the application process by assisting and facilitating the necessary eligibility forms, reviewing continued eligibility, making referrals, and maintaining appropriate levels of benefits.

This position requires processing applications and other documents accurately, determining eligibility, meeting with members for case management, answering incoming calls, and representing the agency at hearings. Ideal candidates will display exceptional customer service and demonstrate an ability to successfully navigate a direct client-contact relationship.

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

Assist individuals and families, individuals with disabilities, and others to determine initial and continued eligibility for MassHealth benefits.\ Process applications and administer case management via phone or in-person.\ Assist members to navigate and complete online applications.\ Evaluate and review submitted documents to ensure accuracy and completeness of information.\ Validate customer demographic, financial, and background data through contacting applicants and collateral sources.\ Provide requested services and appropriate referrals for customers to external programs for which they may qualify.\ Validate customer demographic, financial, and background data.\ Represent the agency at hearings and explain eligibility determinations.\ Reconcile MassHealth case information with information from other agencies and sources.\ Respond to customer inquiries and provide information regarding eligibility requirements.\ Provide quality customer service by responding to inquiries in a professional, efficient, and courteous manner.

Required Qualifications:

  • Active Listening: Listening to others and asking questions when needed.
  • Communication Skills: The ability to understand and express information and ideas orally or in writing.
  • Information Management: Evaluating information against standards and obtaining information from relevant sources.
  • Planning and Organization: Developing plans to accomplish work and prioritizing tasks.
  • Interpersonal Skills: Developing constructive relationships with others, being service-oriented, and socially perceptive.
  • Working with the Public: Dealing directly with clients and others who do business with the organization.
  • Adaptability: Being open to change and able to work in diverse environments.
  • Attention to Detail: Being meticulous and thorough in completing tasks.
  • Dependability: Being reliable, responsible, and dependable in fulfilling obligations.
  • Emotional Intelligence: Demonstrating self-control, persistence, integrity, and stress tolerance in difficult situations.

Preferred Qualifications:

  • Proven experience working with individuals from diverse backgrounds, including those with disabilities, geriatric populations, non-English speakers, and low-income families.
  • Strong organizational skills and ability to manage multiple tasks simultaneously.
  • Excellent communication skills, both oral and written, with the ability to explain complex information to customers in an understandable way.
  • Demonstrated ability to work independently and as part of a team.
  • Experience working in a customer service or call center environment.
  • Ability to maintain strict confidentiality and handle sensitive information appropriately.
  • Proficient in Microsoft Office applications, including Word and Outlook.

About MassHealth:

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