Powered By
Open Positions (18)
Contract Sep 12, 2025 Healthcare
Outreach Resources: Provide resources who are trusted members of the communities served and/or have an unusually close understanding of the communities to facilitate access to health care services, improve the quality and cultural competency of those services, and improve member health outcomes. Outreach Coordinator Resources work to increase health literacy, reduce costs of services, and improve care.
Pay Rate $20.00 hrly.
Monday - Friday 8:00-5:00 pm
Work remotely and local Travel is required
Job Description
The overall approach for outreach workers is fluid and flexible based on identified quality and member outcome needs. The primary focus of the Outreach resources will be as follows:
Understand Member history and the physical, behavioral, and social factors that may be leading to less-than-ideal health outcomes or persistent gaps in care.
Utilize a whole health approach when interacting with Members and caregivers.
Working with Case Management to place outreach resources at point of care facilities to better facilitate member engagement and action.
Facilitate real time gap closure initiatives including but not limited to immunizations, telehealth visits, A1c tests, lead tests, and blood pressure readings.
Pivot priorities as necessary month to month based on HEDIS performance.
Engage member in care coordination and case management as necessary.
Educate member on health care benefits and services and monitor for over and/or underutilization.
Requirements:
Vaccinated Covid and Flu
Home Visits Required
Driver’s License required
High School Diploma/GED required
Preferred:
Community Outreach Experience preferred
Contract Sep 12, 2025 Healthcare Outreach Resources: Provide resources who are trusted members of the communities served and/or have an unusually close understanding of the communities to facilitate access to health care services, improve the quality and cultural competency of those services, and improve member health outcomes. Outreach Coordinator Resources work to increase health literacy, reduce costs of services, and improve care.
Pay Rate $20.00 hrly.
Monday - Friday 8:00-5:00 pm
Work remotely and local Travel is required
Job Description
The overall approach for outreach workers is fluid and flexible based on identified quality and member outcome needs. The primary focus of the Outreach resources will be as follows:
Understand Member history and the physical, behavioral, and social factors that may be leading to less-than-ideal health outcomes or persistent gaps in care.
Utilize a whole health approach when interacting with Members and caregivers.
Working with Case Management to place outreach resources at point of care facilities to better facilitate member engagement and action.
Facilitate real time gap closure initiatives including but not limited to immunizations, telehealth visits, A1c tests, lead tests, and blood pressure readings.
Pivot priorities as necessary month to month based on HEDIS performance.
Engage member in care coordination and case management as necessary.
Educate member on health care benefits and services and monitor for over and/or underutilization.
Requirements:
Vaccinated Covid and Flu
Home Visits Required
Driver’s License required
High School Diploma/GED required
Preferred:
Community Outreach Experience preferred
Contract Sep 12, 2025 Healthcare Outreach Resources: Provide resources who are trusted members of the communities served and/or have an unusually close understanding of the communities to facilitate access to health care services, improve the quality and cultural competency of those services, and improve member health outcomes. Outreach Coordinator Resources work to increase health literacy, reduce costs of services, and improve care.
Pay Rate $20.00 hrly.
Monday - Friday 8:00-5:00 pm
Work remotely and local Travel is required
Job Description
The overall approach for outreach workers is fluid and flexible based on identified quality and member outcome needs. The primary focus of the Outreach resources will be as follows:
Understand Member history and the physical, behavioral, and social factors that may be leading to less-than-ideal health outcomes or persistent gaps in care.
Utilize a whole health approach when interacting with Members and caregivers.
Working with Case Management to place outreach resources at point of care facilities to better facilitate member engagement and action.
Facilitate real time gap closure initiatives including but not limited to immunizations, telehealth visits, A1c tests, lead tests, and blood pressure readings.
Pivot priorities as necessary month to month based on HEDIS performance.
Engage member in care coordination and case management as necessary.
Educate member on health care benefits and services and monitor for over and/or underutilization.
Requirements:
Community Outreach Experience preferred
CHW Certification and/or CNA/HHA preferred
Vaccinated
Home Visits Required
Driver’s License required
High School Diploma/GED required
Contract Sep 11, 2025 Healthcare Position Purpose:
Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.
Schedule: Monday-Friday, 8-5 EST or 9-6 CST
Location: Indiana - REMOTE
Pay: Weekly pay
Job Description:
Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans
Evaluates the needs of the members, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome
Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or services are accessible to members in a timely manner
May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate
Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
May perform on-site visits to assess member’s needs and collaborate with providers or resources, as appropriate
May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits
Other duties or responsibilities as assigned by people leader to meet the member and/or business needs
Performs other duties as assigned
Complies with all policies and standards
Education/Experience:
Requires a Bachelor’s degree and 2 – 4 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
License/Certification:
Current state’s clinical license preferred
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract Sep 10, 2025 Healthcare Job Summary:
Our client is seeks a compassionate Primary Care Physician to provide comprehensive medical care to our long-term psychiatric patient population (ages 18–80+). This unique role emphasizes long-term physician-patient relationships in a collaborative, multidisciplinary environment. Unlike traditional hospitalist roles, you’ll manage a small panel of patients (60–80 total, with
Key Responsibilities:
Deliver primary care services to adults with severe mental illness, including preventive care, chronic disease management, and acute interventions.
Collaborate closely with psychiatrists, psychiatric NPs, nurses, and treatment teams to integrate medical and behavioral health care.
Develop personalized care plans for patients with extended lengths of stay (months to years).
Document care in compliance with TJC standards and participate in quality improvement initiatives.
Mentor and support clinical staff as needed.
Requirements:
Medical Degree (MD/DO) with board certification/eligibility in Family Medicine, Internal Medicine, or Med-Peds.
Preferred: Full, unrestricted Missouri medical license (will consider unlicensed applicants completing training).
Experience in primary care, geriatrics, or chronic disease management preferred; new graduates welcome.
Ability to thrive in a team-based setting with psychiatrists and behavioral health professionals.
Contract Sep 10, 2025 Healthcare Licensed Practical Nurse (LPN), Washington, DC
shifts are structured as split shifts. A staff member may work up to two split shifts per day. For example:
AM Shift: 5:00 AM – 9:30 AM
PM Shift: 3:30 PM – 7:00 PM
Position Summary:
We are seeking a compassionate and dedicated Licensed Practical Nurse (LPN) to provide essential medical support and supervision during the transportation of school-aged students with special needs. This critical role ensures the health, safety, and well-being of our most vulnerable students while they are in transit to and from school. The ideal candidate will be a skilled clinician with a calm demeanor, able to respond to medical needs and manage the unique challenges of a mobile environment.
Key Responsibilities
Direct Patient Care & Medical Support:
Provide direct nursing care to students with special needs as prescribed and in accordance with state LPN practice acts and district policies.
Monitor students' physical and emotional status throughout transport, identifying and responding to changes in condition.
Manage and respond to medical emergencies and follow established emergency action plans.
Operate and maintain specialized medical equipment (e.g., ventilators, oxygen tanks, feeding pumps, monitors) securely within the vehicle.
Safety & Compliance:
Ensure all students are properly secured in their safety restraints, car seats, or wheelchair security systems according to state law and individual student plans.
Maintain a clean, sanitized, and safe environment on the bus to prevent the spread of infection.
Adhere strictly to HIPAA and FERPA regulations, maintaining student confidentiality at all times.
Communication & Documentation:
Communicate effectively with parents/guardians at pickup and drop-off regarding the student's condition, needs, or any incidents that occurred during transport.
Provide a clear and concise report to school nurses, teachers, and aides upon arrival at school and at the end of the day.
Maintain accurate, detailed daily logs of care provided, student observations, medication administration, and incident reports.
Operational Duties:
Ride the school bus or specialized transport vehicle on assigned routes.
Assist the bus driver with loading, unloading, and positioning of students.
Manage student behavior to ensure a safe and calm environment for all riders.
Qualifications Required:
Current and valid Licensed Practical Nurse (LPN) license in the state of District of Columbia.
Current CPR and First Aid certification.
Valid driver's license with a clean driving record.
Minimum of 1-2 years of nursing experience, preferably in school nursing, emergency care, or with individuals with special needs.
Ability to lift, position, and assist students of various sizes and with physical disabilities (e.g., transferring to and from wheelchairs).
Preferred:
Experience in a school setting or with pediatric patients.
Knowledge of common childhood disabilities and medical conditions.
Training in behavior management or de-escalation techniques.
Skills & Abilities:
Exceptional clinical assessment and critical thinking skills.
Strong interpersonal and communication skills to interact with children, parents, and school staff effectively.
Patience, empathy, and a nurturing demeanor.
Ability to remain calm and make sound decisions under pressure in a mobile environment.
High level of organization and attention to detail for documentation and compliance.
Working Conditions
Work is performed primarily inside a school transportation vehicle.
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Data & Operations Analyst
Location: Remote within Indiana 25% Travel
Hours: Standard business hours M-F 8am-5pm
Benefits: Health, dental, and vision benefits, 80 hours of PTO, 10 paid holidays, 401k, and supplemental insurance
About the Role
As the LTSS Provider Data & Operations Analyst, you’ll be the go-to expert for ensuring the accuracy, integrity, and optimization of provider data that powers our Long-Term Services and Supports (LTSS) network. Your work will directly impact how providers are onboarded, supported, and connected to the individuals they serve.
You’ll analyze complex datasets, resolve data issues, improve processes, and work closely with both internal teams and external partners to ensure smooth operations and regulatory compliance. This is a role for someone who is detail-oriented, analytical, and collaborative — with the drive to turn data into actionable insights that improve outcomes.
What You’ll Do
Analyze LTSS provider data to track performance, identify trends, and create actionable reports for leadership and partners.
Conduct regular audits to identify data discrepancies, assess downstream impacts, and implement corrections.
Build dashboards and visual tools to support decision-making and monitor provider network health.
Serve as the Subject Matter Expert for LTSS provider data load requirements, ensuring accuracy and consistency across systems.
Partner with LTSS Provider Relations leadership to make provider data updates and resolve related issues.
Maintain alignment between Facets, SPS, and other downstream systems to prevent data conflicts.
Manage and resolve provider data tickets submitted by the local LTSS Provider Relations team.
Collaborate with operations teams to improve provider data workflows and service delivery processes.
Work closely with Provider Data Solutions (PDS) teams to align policies, procedures, and desktop processes.
Lead provider data review meetings to discuss audit results, upcoming changes, roster submissions, and DART loads.
Requirements
Minimum Qualifications
Bachelor’s degree in Health Administration, Data Analytics, or related field (Master’s preferred).
2–3 years of experience in data management, healthcare operations, or similar role.
Proficiency in Excel and experience with SQL, Tableau, or similar data tools.
Understanding of LTSS programs, provider operations, and related regulations.
Strong communication skills and the ability to work with multiple teams.
Exceptional attention to detail and a commitment to data integrity.
Preferred Skills
Healthcare industry experience, ideally with LTSS or Medicaid programs.
Experience with Snowflake and/or advanced SQL queries.
Strong Excel skills, including pivot tables, lookups, and data modeling.
Ability to manage multiple priorities independently.
Project leadership experience.
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Merrillville and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Salem and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Fort Wayne and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Sep 9, 2025 Healthcare Medical Claims Processor I to be responsible for the accurate and timely processing of claims. Support the overall quality effectiveness to ensure that all claims are processed accurately and complete to ensure appropriate adjustment code usage, and payment rate.
Schedule: Monday-Friday, 8:00 AM-5:00 PM during Training
Location: 160 Dozier Blvd Florence, SC 29501
Pay: Weekly pay
Research and processes claims according to business regulation, internal standards and processing guidelines.
Verifies the coding of procedure and diagnosis codes.
Resolve system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
Required Skills and Abilities:
Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills.
Required Software and Tools:
Basic office equipment. Proficient in word processing and spreadsheet applications. Proficient in database software.
Required Education:
High School Diploma or equivalent
Required Work Experience:
1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities:
Ability to use complex mathematical calculations.
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Evansville and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Aug 26, 2025 Healthcare Healthcare Claims Processor I to be responsible for the accurate and timely processing of claims. Support the overall quality effectiveness to ensure that all claims are processed accurately and complete to ensure appropriate adjustment code usage, and payment rate.
Schedule: Monday-Friday, 8:00 AM-5:00 PM during Training
Location: 8733 Highway 17 Bypass, Myrtle Beach
Pay: Weekly pay
Research and processes claims according to business regulation, internal standards and processing guidelines.
Verifies the coding of procedure and diagnosis codes.
Resolve system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
Required Skills and Abilities:
Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills.
Required Software and Tools:
Basic office equipment. Proficient in word processing and spreadsheet applications. Proficient in database software.
Required Education:
High School Diploma or equivalent
Required Work Experience:
1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities:
Ability to use complex mathematical calculations. Contract Aug 21, 2025 Administrative Job Title: Data Capture Specialist
Location: Marion, Indiana
Work Schedule (Part-Time): Monday: 9:00 AM – 6:00 PM
Wednesday: 9:00 AM – 5:30 PM
Friday: 9:00 AM – 5:30 PM
Pay: $14.85hr (Weekly Pay)
Job Summary:
The Data Capture Specialist is responsible for accurately keying information and scanning various documents.
Duties and Responsibilities:
Accurately enter alphabetic and numeric data from electronic images with speed and precision
Read, analyze, and classify documents according to specified criteria
Operate and maintain scanning equipment, including making adjustments to ensure optimal image quality
Review completed work and follow company quality control procedures to ensure accuracy standards are met
Support the team in meeting daily/monthly KPIs and SLAs
Follow proper procedures for data capture and QA
Maintain confidentiality and comply with PHI/PII safeguards, reporting any concerns promptly
Requirements:
High school diploma or equivalent
Proficiency in MS Office (Word, Outlook, Teams, SharePoint)
Excellent typing skills (touch, 10-key, 45+ WPM)
Ability to pass reference checks, drug screen, and background check
Contract Aug 21, 2025 Administrative Job Title: Data Capture Specialist
Location: Marion, Indiana
Work Schedule (Part-Time): Monday: 1:00 PM – 6:00 PM
Tuesday – Friday: 1:00 PM – 5:30 PM
Pay: $14.85hr (Weekly Pay)
Job Summary:
The Data Capture Specialist is responsible for accurately keying information and scanning various documents.
Duties and Responsibilities:
Accurately enter alphabetic and numeric data from electronic images with speed and precision
Read, analyze, and classify documents according to specified criteria
Operate and maintain scanning equipment, including making adjustments to ensure optimal image quality
Review completed work and follow company quality control procedures to ensure accuracy standards are met
Support the team in meeting daily/monthly KPIs and SLAs
Follow proper procedures for data capture and QA
Maintain confidentiality and comply with PHI/PII safeguards, reporting any concerns promptly
Requirements:
High school diploma or equivalent
Proficiency in MS Office (Word, Outlook, Teams, SharePoint)
Excellent typing skills (touch, 10-key, 45+ WPM)
Ability to pass reference checks, drug screen, and background check
Contract To Hire Aug 12, 2025 Healthcare Claims Customer Service Advocate II to be responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures.
Schedule: Monday-Friday, 8:00 AM-5:00 PM during Training
Location: 8733 Highway 17 Bypass, Myrtle Beach
Pay: Weekly pay
• Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.
• Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards.
• Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations.
Required Skills and Abilities:
Good verbal and written communication skills. Strong customer service skills. Good spelling, punctuation and grammar skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion.
Required Software and Other Tools:
Microsoft Office. Work Environment: Typical office environment.
Required Education:
High School Diploma or equivalent
Required Work Experience:
2 years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Contract Jul 23, 2025 Healthcare Job Title: Health Coach
Hours: M-F 8am-5pm
Location: Indianapolis, IN
Description:
Responsible for providing health coaching to members, across all brands, with chronic diseases. Primary duties may include, but are not limited to: Conducts behavioral assessments to identify individual member knowledge, skills, and behavioral needs. Coordinates specific health coaching as directed by nurse case manager to address objectives and goals as identified during assessment. Implements coaching plan by using behavior change principles to identify member barriers and develop ways to overcome those barriers. Coordinates with the nurse case manager to provide feedback on member goal attainment and clinical issues. Monitors and evaluates the interventions and modifies.
Position Summary: This Onsite Health Coach position requires 50-75% travel throughout the north region of IN to support client wellness events anywhere from 3-4 days/week most weeks. The remainder of the time will be spent working from home when not traveling to client locations and providing virtual support through webinars, group coaching, outreach, phone calls, planning meetings and documenting interactions when onsite. The Onsite Health and Wellness Coach utilizes a collaborative process, in conjunction with the client's wellness champions, to plan and implement wellness events and programs to promote and influence members in decisions related to achieving and maintaining optimal health status. The goal of these programs and events is to help members achieve healthy lifestyle behaviors and align these lifestyle behaviors with individual wellness goals.
Details: The Onsite Health and Wellness Coach will act as the face of the health and wellness programs for this client while promoting healthy behavior change and engagement in available health and wellness program.
• Support wellness events in the workplace including but not limited to wellness challenges, health fairs, presentations, biometric screenings and individual and group coaching both in person and virtually
• Build relationships with wellness champions/site contacts through outreach phone calls, emails and drop ins.
• Promote and build awareness around internal and vendor partners health and wellness programs and resources.
• Deliver health and well-being education and coaching on topics including weight management, stress management, tobacco cessation, healthy eating, physical activity, sleep, prediabetes, prehypertension, preventative health and other healthy lifestyle topics.
• Create awareness, drive healthy behavior changes, increase engagement and help to positively impact the health and wellbeing of employees for this client.
• Help to create a culture of health and wellbeing across the client’s locations.
Required Qualifications:
• 3+ years of experience with healthy lifestyle coaching in at least 4 of the following areas: weight management, tobacco cessation, nutrition, physical activity and/or stress management.
• 3+ years of experience in facilitating patient/client positive behavioral change.
• 3+ years of experience with Word, Outlook, PowerPoint, and documentation systems
• 3+ years supporting workplace wellness events such as health fairs, biometric screenings, presentations, activity booths and supporting individual and group coaching
• 3+ years experience presenting to audiences both onsite and virtually on health related topics
• 3+ years experience building/creating wellness champion networks and building relationships to help support employee well-being
Requires BA/BS in appropriate field of specialization (examples such as Health Education, Exercise Physiology, Respiratory Therapy or Dietician) and minimum of 3 years of related experience in health education, exercise instruction, or patient education; or any combination of education and experience, which would provide an equivalent background. Certification, advanced certification, and/or license appropriate to field of specialty as required. Prior experience in health coaching, disease management and knowledge of behavioral and/or clinical assessment techniques, health and/or patient education and behavior change techniques preferred. Understanding of disease management principles preferred.
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law. Contract Jun 30, 2025 Administrative Job Summary
Data Capture Specialist is responsible for the accurate keying of information and scanning various documents.
Pay: 14.85/hour
Onsite Position - Marion, IN
Duties and Responsibilities
The responsibilities of the Data Capture Operator are outlined as follows and no intended to be all inclusive:
Accurately entering alphabetic and numeric data from electronic images with speed and accuracy utilizing software application to capture the appropriate data.
Reading, analyzing, and classifying documents based on certain assigned criteria.
Operating and maintaining scanning equipment, including processing documents through scanner and making appropriate adjustments to improve image capture.
Reviewing completed work and administering the company’s quality control procedures to ensure work is at or above required accuracy rates.
Assisting entire team in meeting daily and monthly KPIs and SLAs.
Following proper procedures, rules, and processes for data capture and quality assurance of data.
Utilizing appropriate and compliant safeguards to reasonably prevent the improper use or disclosure of confidential and protected information which may include Protected Health Information (PHI) and/or Personally Identifiable Information (PII) and reporting any concerns to manager.
Knowledge, Skills, and Abilities
High School Diploma or equivalent required.
Proficiency is MS Office (Word, Outlook, Teams, SharePoint).
Excellent typing skills—touch, 10 key, 45 wpm
Ability to pass reference checks, drug screen, and background checks.
Work Schedule
Monday: 9:00 a.m. - 6:00 p.m.
Tuesday: 9:30 a.m. - 5:30 p.m.
Wednesday through Friday: 9:00 a.m. - 5:30 p.m.