National Avg. Salary

$43,040 More Salary Data →

Job Growth Rate

1.6% More Growth Data →

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A medicare benefits caseworker takes the lead on coordinating and making decisions regarding Medicaid benefits application process, over multidisciplinary bodies to obtain eligibility for those patients that are entitled to such insurance.

Checkmark What is a Medicare Benefits Caseworker?


The Medicare Benefits Caseworker performs a number of essential duties including:

  • Undertake accurate and in-depth reviews of a patient’s case to assess eligibility for medical assistance programs or the purchase of medical care insurance where applicable.
  • Assess assigned patient’s assets, clinical past, dependent responsibilities and financial status based on the principles laid out by federal agencies and the social security administration guidelines.
  • Oversee the patient’s ongoing care requirements and determine the best possible program or certification period to reduce patient deductibles and increase entity reimbursements.
  • On a case-by-case basis, perform the role of a patient’s representative for beginning an application for medicare benefits or conducting activities that involve evaluating the eligibility of benefits, i.e. the entire process of administrative or judicial appeals.
  • Review multiple case files to pinpoint underlying issues and find sufficient evidence or documentation, in accordance with Social Security Administration rules and the Division of Medical Assistance guidelines.

Day In The Life

The primary task of a medicare benefits caseworker is to critically review all applications for Medicaid programs and support applications that are eligible. This will entail doing regular follow-ups with individuals and making sure that all forms are filled up accurately. As a medicare benefits caseworker, you also have a legal liability, since it is your job to ensure that correct actions are taken on behalf of a client as per the county and state regulations. Besides performing frequent fact-checks, you will be a source of guidance for individuals that are looking for financial support.

In addition, you may work as an advocate or guidance counsellor to give information to interested applicants, Social Workers, Physicians, Clinic and Admissions personnel, etc. regarding which aid programs are beneficial for them and appropriate for their family or home environment. This will require travel to the county of patient residency to transport a patient if required, to the Department of Social services for follow- up visits, get additional records, and verify or correct incorrect data on behalf of the patient.

Maintaining certain documentation and routine paperwork, along with computerized records is a must in the day to day schedule of an average medicare benefits caseworker. In addition to preparing and maintaining client files, you will need to schedule client appointments and make a note of any changes in the policies of the organization.

Work Schedule

Medicare benefits caseworkers are typically employed full-time and work during standard business hours. However, part-time opportunities may also be available, over evenings and on the weekends. Depending on the organization, you must possess a valid driver’s license to commute to the residences of clients, varied places of employment or any other setting.

Growth Of The Job

The future demand for medicare benefits caseworkers is expected to increase by 12 percent between 2014 to 2024, as reported by the Bureau of Labor Statistics.

Typical Employers

In this role, you will find promising job opportunities with government agencies as advisers and fact-checkers, tasked with reviewing a wide range of applications for medicare and other aid programs. You may also work with mental health clinics, hospitals, assisted-living facilities and other healthcare centers. Further, medicare benefits caseworkers are employed by different community based and humanitarian organizations, working towards child welfare or at immigrant and refugee services agencies.

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Clipboard How To Become a Medicare Benefits Caseworker

The exact educational requirements for caseworkers vary from employer to employer. At minimum, you should at least possess a Bachelor’s degree in a relevant subject like business studies, administration, business management, healthcare, finance, accounting. In such programs, you will gain the skills required to perform administrative operations smoothly and familiarize yourself with concepts in human resources, public relations, marketing, etc. Another alternative is to earn a bachelor’s degree in social work, through which you would master an understanding of ways to improve a person’s well-being with the support of socioeconomic policies in place.

Beyond educational qualifications, medicare benefits caseworkers should cultivate work experience in their industry and be well-versed with best practices to deal with various circumstances. Being computer-efficient and having command of multiple languages is also an advantage, since you will have many interactions with non-native English speakers or clients of different ethnicity who cannot speak English.

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Wallet Medicare Benefits Caseworker Salary Data

We've provided you the following to learn more about this career. The salary and growth data on this page comes from recently published Bureau of Labor Statistics data while the recommendations and editorial content are based on our research.

National Annual Salary

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Average Average


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National Hourly Wage

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Average Average


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How do Medicare Benefits Caseworker salaries stack up to other jobs across the country? Based on the latest jobs data nationwide, Medicare Benefits Caseworker's can make an average annual salary of $43,040, or $21 per hour. This makes it an Above Average Salary. On the lower end, they can make $34,380 or $17 per hour, perhaps when just starting out or based on the state you live in.

Salary Rankings And Facts

  • #476 Nationally for All Careers

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Graduation Cap Programs and Degrees

Here are the most common degrees for becoming a Medicare Benefits Caseworker. a Bachelor's is usually recommended and specifically a degree or coursework that prepares you for the particular field, see below.

Chart Highest Education Among Medicare Benefits Caseworker

  • 0.9%   Doctorate
  • 9%   Masters
  • 36.2%   Bachelors
  • 12.8%   Associates
  • 25.6%   College
  • 14.3%   High School
  • 1.2%   Less than High School

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Chart Up Job Growth Projections and Forecast

2014 Total Jobs


2024 Est. Jobs


Job Growth Rate


Est. New Jobs


How does Medicare Benefits Caseworker job growth stack up to other jobs across the country? By 2024, there will be a change of 2,100 jobs for a total of 132,000 people employed in the career nationwide. This is a 1.6% change in growth over the next ten years, giving the career a growth rate nationwide of Below Average.

Growth Rankings And Facts

  • #561 Nationally for All Careers

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Employee What Companies Employ The Most Medicare Benefits Caseworkers

IndustryCurrent JobsNew Jobs Needed% Increase
Local government, excluding education and hospitals 50,100 2,800 3%
State government, excluding education and hospitals 45,300 700 1%
Federal government, excluding postal service 26,000 -2,500 -3%

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