Commonwealth of Massachusetts

Benefit Eligibility & Reimbursement Social Worker

Commonwealth of Massachusetts  •  $74k - $100k/yr  •  Tewksbury, MA (Hybrid)  •  3 hours ago
Apply
AI can make mistakes so check important info. Chat history is never stored.

Job Description

Benefit Eligibility & Reimbursement Social Worker-(260004XT)

The Massachusetts Department of Public Health (DPH) at Tewksbury Hospital is seeking an experienced leader to serve as the Benefit Eligibility & Referral Social Worker Supervisor (BERS Social Worker C).In this role, you will lead a dedicated team responsible for helping patients and long-term care residents navigate complex financial, insurance, and public benefit programs that support access to essential healthcare services.

This is a great opportunity for a collaborative professional who enjoys mentoring staff, improving processes, and solving complex eligibility and financial counseling challenges. You will work closely with interdisciplinary healthcare teams, hospital leadership, MassHealth, Social Security, and community partners to remove barriers to treatment, strengthen patient outcomes, and support efficient hospital operations. DPH offers a mission-driven environment where your leadership will directly improve the lives of vulnerable individuals while providing opportunities for professional growth, meaningful collaboration, and public service.

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

·Provides day-to-day supervision and guidance to Benefits Eligibility & Referral Social Worker (A/B) staff performing financial counseling, private-pay assessments, registration, insurance verification, and encounter billing.

·Monitors the timeliness and accuracy of financial counseling and private pay assessments, ensuring consistent use of the hospital sliding fee scale and clear documentation of financial recommendations.

·Oversees registration workflows for new and returning patients, verifying that demographic, contact, insurance, and guarantor information is properly collected and updated in applicable systems.

·Develops, implements, and maintains standardized processes, templates, and tracking tools for MassHealth LTC applications, renewals, and related activities to promote timeliness and consistency.

·Develops, implements, and maintains standardized processes, templates, and tracking tools for MassHealth LTC applications, renewals, and related activities to promote timeliness and consistency.

·Provides advanced consultation to staff on complex Social Security and federal benefit matters, including SSI/SSDI eligibility, overpayments, appeals, suspensions, and reinstatements.

·Designs and maintains department-level tracking systems (e.g., spreadsheets, databases, dashboards) to monitor MassHealth eligibility, applications in progress, SC 1 activity, redeterminations, and key deadlines.

·Provides oversight and consultation on cases involving immigration status and USCIS processes, ensuring that staff appropriately identify immigration related barriers that affect benefits and discharge planning.

·Oversees staff review of Personal Needs Accounts (PNA) balances and asset levels to identify patients exceeding allowable benefit thresholds.

·Oversees staff management of SORB related requirements, including tracking of annual fees, reporting obligations, and documentation requirements for designated patients.

·Oversees staff completion of Disabled Persons Protection Commission (DPPC) reports, ensuring that mandated reporting requirements are understood and consistently met.

Required Qualifications:

·Knowledge of the methods and standards of general report writing.

·Ability to read, interpret, apply, and explain laws, rules, regulations, policies, procedures, specifications, standards, and guidelines governing assigned areas.

·Ability to gather information through questioning and by examining records and documents.

·Ability to conduct interviews effectively and professionally.

·Ability to accurately record information provided orally.

·Ability to communicate clearly and effectively, both orally and in writing.

·Ability to write concisely, express thoughts clearly, and develop ideas in logical sequence.

·Ability to maintain accurate and organized records.

·Ability to perform arithmetic computations with speed and accuracy.

·Ability to assemble items of information in accordance with established procedures.

Preferred Qualifications:

·Experience supervising staff in a healthcare, hospital, long-term care, or human services setting.

·Strong knowledge of MassHealth/Medicaid, Medicare, commercial insurance, and benefit eligibility programs.

·Experience managing long-term care (LTC) MassHealth applications, renewals, and appeals.

·Familiarity with Social Security (SSI/SSDI), disability benefits, and other federal assistance programs.

·Experience interpreting and applying state and federal healthcare regulations, including HIPAA and eligibility requirements.

·Demonstrated ability to analyze complex financial or benefit eligibility cases and develop effective solutions.

·Experience collaborating with interdisciplinary healthcare teams to support patient care and discharge planning.

·Proficiency with electronic health records, eligibility verification systems, databases, and Microsoft Office applications, including Excel.

·Excellent leadership, communication, organizational, and customer service skills with a commitment to promoting equitable access to healthcare services.

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.

About Tewksbury Hospital:

Tewksbury Hospital offers a broad range of services including a physician on site at all times, around-the-clock nursing care, rehabilitation services including physical therapy, occupational therapy, and speech therapy, psychology services, social services, nutritional services, and an on-site dialysis clinic.

Learn more https://www.mass.gov/locations/tewksbury-hospital

Pre-Hire Process:

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 concerning this requisition, please contact Employment and Staffing Customer Service at 1-800-510-4122, #4.

For technical questions accessing MassCareers, please contact Mass HR at 617-979-8500.

ADA Reasonable Accommodation:

If you require a reasonable accommodation with the application/interview process, please contact us at: EOHHS Candidate ADA Requests

Qualifications

First consideration will be given to those applicants that apply within the first 14 days.

MINIMUM ENTRANCE REQUIREMENTS:

REQUIRED WORK EXPERIENCE: At least four years of full-time, or equivalent part-time, professional 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 two years of 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 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.

Comprehensive Benefits

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.

Want the specifics?Explore our Employee Benefits and Rewards!

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 / 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 TitleBenef Elig & Refer Soc Wrk (C)

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

Jul 24, 2026, 6:37:11 PM

Number of Openings

1

Salary

73,555.04-99,932.82Yearly
If you have Diversity, Affirmative Action or Equal Employment Opportunity questions or need a Reasonable Accommodation, please contact Diversity Officer / ADA CoordinatorSandra Semedo: sandra.c.semedo@mass.gov-8573197225
Bargaining Unit08-SEIU - Local 509 - Social/Rehabilitation
ConfidentialNo
Potentially Eligible for a Hybrid Work ScheduleNo
Commonwealth of Massachusetts

About Commonwealth of Massachusetts

Year after year, the Commonwealth of Massachusetts has continued to pioneer bold legislative actions and programs, some of which have been embraced on a national scale. We are always looking for talented individuals to help us maintain this momentum and improve the services that millions of people depend on every day.

If you’re looking for an innovative work environment where you can really make a difference, check out the job opportunities with the Commonwealth of Massachusetts.

This page is managed according to the Mass.gov social media policy: https://www.mass.gov/info-details/massgov-social-media-policy. Comments that do not follow our policy may be removed.

Industry
Government & Public Safety
Company Size
10,000+ employees
Headquarters
Boston, MA
Year Founded
1788
Website
mass.gov
Social Media