Job Details

Job Title

Medical Insurance Intake Specialist

The 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 Responsibilities

• Serve 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.

Required Qualifications

• 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).

Preferred / Desirable Qualifications

• 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.).