Medical Insurance Customer Service
2 days ago
Job Title
Medical Insurance Intake Specialist
LocationRemote
About Trusted Surplus SolutionsThe organization navigates complex financial, legal, and medical eligibility issues to help clients access Medicaid home care benefits and manage funds in compliance with federal and state rules.
As an Intake Specialist, you'll play a crucial role in connecting prospective clients to the services they need and ensuring the intake process is smooth, compliant, and compassionate.
Key ResponsibilitiesServe as the first point of contact for incoming prospective clients (via phone, email, web forms).
Conduct intake interviews to gather essential personal, medical, and financial information to assess eligibility for pooled trust / Medicaid-related services.
Explain the services, benefits, and requirements of the program in clear, accessible language.
Document intake data accurately in CRM systems or internal databases, ensuring all required fields are completed.
Coordinate with legal, financial, and case management teams to route each intake for evaluation.
Screen for missing information or red flags and request follow-up documentation when needed.
Maintain confidentiality and comply with HIPAA and relevant privacy / data security standards.
Track metrics such as number of intakes, dropped leads, follow-up rates, and escalate issues as needed.
Provide follow-up calls or emails to applicants to clarify details or request additional data.
Stay up to date on Medicaid rules, pooled trust guidelines, and state regulations affecting eligibility.
Assist in improving the intake process (templates, scripts, forms) for efficiency and clarity.
Bachelors degree (or equivalent experience) in Social Work, Public Health, Health Administration, or related field preferred.
Previous experience in intake, case management, social services, or healthcare settings.
Basic understanding of Medicaid, SSI, eligibility rules, or trust / benefit programs is a strong plus.
Strong communication skills (verbal and written), with ability to explain complex rules simply.
Exceptional organizational skills and attention to detail.
Tech-savvy: experience working with CRM systems, Microsoft Office / Google Workspace, databases.
Ability to work independently, manage workload, and follow up consistently.
Sensitivity and empathy toward clients with disabilities, the elderly, and individuals in vulnerable situations.
Commitment to privacy / confidentiality and ability to handle sensitive client data.
Reliable internet connection and a suitable work environment (if remote).
Experience working with trusts, financial benefit programs, or social benefits administration.
Familiarity with HIPAA compliance and healthcare privacy laws.
Experience triaging clients or screening for eligibility.
Multilingual skills, especially with client populations (e.g. Spanish, etc.).
-
Medical Insurance Application Specialist
13 hours ago
Cape Town, Western Cape, South Africa EXL Full timeThe Medical Insurance Application Specialist plays a crucial role as the first point of contact for patients or new members seeking medical insurance coverage. This position involves guiding applicants through the enrollment process, verifying eligibility, and ensuring that all required documentation is completed accurately and on time.Key Responsibilities...
-
Executive-Voice-Customer Service
2 weeks ago
Cape Town, Western Cape, South Africa EXL Service Full time R104 000 - R208 000 per yearJob DescriptionDemonstrate a strong customer focus that enables to arrive at fair outcomes for the customer resulting in securing payments to BG and getting the customer's energy account back on trackAchieve high call quality, meet compliance standards whilst delivering against agreed collections performance metrics Fully assess the customers circumstances...
-
Executive-Voice-Customer Service
2 weeks ago
Cape Town, Western Cape, South Africa EXL Service Full time R104 000 - R150 000 per yearJob DescriptionDemonstrate a strong customer focus that enables to arrive at fair outcomes for the customer resulting in securing payments to BG and getting the customer's energy account back on trackAchieve high call quality, meet compliance standards whilst delivering against agreed collections performance metrics Fully assess the customers circumstances...
-
ZAF - Customer Service Advisor- Travel Insurance
2 weeks ago
Cape Town, Western Cape, South Africa Teleperformance Full time R120 000 - R240 000 per yearOverviewDealing effectively with inbound calls regarding a range of products and transactions is what's involved here. A real chance to make the most of your excellent customer service skills. You'll spend each day identifying and fulfilling a variety of needs, including bringing on board new customers, retaining existing ones and cross-selling at every...
-
Cape Town, Western Cape, South Africa Teleperformance Full timeOverviewDealing effectively with inbound calls regarding a range of products and transactions is what's involved here. A real chance to make the most of your excellent customer service skills. You'll spend each day identifying and fulfilling a variety of needs, including bringing on board new customers, retaining existing ones and cross-selling at every...
-
Customer Service
1 week ago
Cape Town, Western Cape, South Africa ABC Worldwide Full time R150 000 - R250 000 per yearCustomer Service Advisor Job FunctionThe Advocate represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative / clerical / operational / customer support/computational tasks. Typically works on routine and patterned assignments. The Advocate understands and...
-
Independent Registered Medical Practitioner
2 weeks ago
Cape Town, Western Cape, South Africa Medical Resources Group (Pty) Ltd Full time R900 000 - R1 200 000 per yearAbout Medical Resources Group:Medical Resources Group is a leading healthcare agency dedicated to providing exceptional medical services and support. We connect skilled medical professionals with opportunities in various healthcare settings across Western Cape. Join our network to enhance your career and make a significant impact in the healthcare...
-
Customer Service Consultant
2 weeks ago
Cape Town, Western Cape, South Africa abc Full time R360 000 - R600 000 per yearJob FunctionThe Advocate represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative / clerical / operational / customer support/computational tasks. Typically works on routine and patterned assignments. The Advocate understands and addresses customer needs which...
-
Customer Service Consultant
2 weeks ago
Cape Town, Western Cape, South Africa abc Full time R120 000 - R182 500 per yearJob FunctionThe Advocate represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative / clerical / operational / customer support/computational tasks. Typically works on routine and patterned assignments. The Advocate understands and addresses customer needs which...
-
Cape Town, Western Cape, South Africa EXL Service Full time R1 200 000 - R2 400 000 per yearJob DescriptionPRINCIPAL ACCOUNTABILITIESAccountabilities Ensure seamless transition and flawless service delivery Focus on transition with 'Zero' impact on service delivery Focus on efficiencies - leaner, greener and faster Focus on Process stabilization & sustained delivery Reducing operation costs Make TBP more effective Build effective process...