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Contract Nov 3, 2025 Healthcare
Registered Nurse
Staffing
Professional Management Enterprises (PME)
Education
Registered Nurse (RN) Degree
Have a valid RN State of Illinois License
Experience
Training in crisis management techniques, trauma-informed care, and relevant experience working with individuals in crisis situations.
Strong interpersonal skills, empathy, and the ability to remain calm under pressure are essential for this role.
Nurses in this role need strong clinical skills, communication abilities, and the ability to work independently.
Job Description
Responsible for providing telephonic triage, health advice, assessing symptoms, and determining the appropriate course of action, which may include recommending self-care, scheduling appointments, or advising on emergency care.
Job Details
Educate individuals on the importance of nutrition, safety, and overall good health.
Provide knowledge and advice through our triage line.
Engage callers to assess and de-escalate uneasy situations in the least restrictive manner to ensure caller safety over the phone.
Report to assigned supervisor and actively seek consultation whenever necessary or requested by supervisor.
Build rapport with team members that fosters a team culture promoting values and vision.
Actively participate in quality improvement activities to promote continual growth and improvement in quality of services provided.
Completion of required documentation within established time frames.
Use of an Electronic Client Record, and additional call management software.
Maintain applicable licensure requirements.
Maintain intake notes, agency resource records, and documentation.
Maintain familiarity with, and adhere to, program policies and procedures.
Maintain confidentiality of privileged information and adhere to client privacy laws.
Document all critical incidents and utilize all agency procedures for proper documentation and record keeping.
Stay up to date on all required trainings.
Pay
$30
Job Type
Full-Time and Part-Time
Shift and schedule
Scheduled shift range between 4, 8 and 12 hours, based on availability.
Shift Windows:
Morning: 5 AM – 3 PM
Afternoon: 11 AM – 9 PM
Night: 7 PM – 7 AM
Work Setting
Remote
Contract Oct 28, 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 Oct 22, 2025 Administrative 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 Oct 16, 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 Oct 16, 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 Oct 16, 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
Driver’s License required
High School Diploma/GED required
Contract Oct 16, 2025 Healthcare Behavioral Health Clinical Intake Clinician - Remote
Indianapolis, IN
Description
Behavioral Health – Utilization Management - Clinical Intake Clinician
We’re looking for a Clinical Intake Clinician who can combine clinical expertise with strong communication skills to connect members with the right level of care. This role is mostly provider-facing, with some member interaction to gather information and guide care decisions.
Hours: M-F 8am-5pm
10 paid holidays
80 hours PTO
Pay: $79,000-$83,000/yr
What You’ll Do:
Review and manage behavioral health benefits for psychiatric and substance use treatment (inpatient, outpatient, and facility-based) through phone and written reviews.
Use screening criteria, clinical judgment, and UM guidelines to ensure members get medically necessary, cost-effective care.
Refer cases to Peer Reviewers when needed.
Coordinate and monitor care plans to promote quality outcomes and effective use of benefits and community resources.
Support BH Care Managers and handle complex cases.
Contribute to team projects and department initiatives.
What You’ll Bring:
Strong clinical knowledge in behavioral health.
Ability to assess needs, plan care, and collaborate with providers.
Commitment to quality care and cost-effective solutions.
Requirements
Master’s degree in social work, counseling, or a related behavioral health field or a degree in nursing.
At least 3 years of experience in facility-based and/or outpatient psychiatric or substance use treatment (or equivalent combination of education and experience).
Current, active, unrestricted license in the U.S. such as RN, LCSW, LMHC, LMFT, or Clinical Psychologist.
Prior experience in case management/utilization management, including complex psychiatric and substance use cases.
Managed care experience required.
Strong oral, written, and interpersonal communication skills, plus problem-solving, facilitation, and analytical abilities
Contract Oct 6, 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 or 1 shift in the am or pm.
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 30, 2025 Administrative Workforce Development Coordinator – Housing Supports & Social Determinants of Health (SDoH)
Location: Indiana (Statewide travel required)
Organization: Professional Management Enterprises (PME) is a Minority-owned business dedicated to delivering innovative workforce solutions and community-based services. With a strong focus on equity and inclusion, PME partners with healthcare providers, government agencies, and community organizations to remove barriers and strengthen systems of care. Our mission is to empower individuals and families, creating pathways to healthier, more stable futures.
Position Summary
The Workforce Development Coordinator will play a key role in supporting Medicaid members across Indiana in improving their employability and achieving long-term economic stability. This individual will assist members in building job readiness skills, accessing training and certification programs, and navigating employment opportunities. The coordinator will also develop and maintain strategic partnerships with employers, human resources departments, and workforce agencies to expand career pathways for members. The coordinator will work closely with Community Health Workers (CHWs) statewide to address employment-related social determinants of health (transportation, childcare, housing, financial strain) and ensure members are supported through the full employment journey; from training to job placement and retention. This position requires regular statewide travel. Candidates must have access to a personal vehicle (mileage reimbursement provided).
Key Responsibilities
· Serve as the primary contact for members seeking workforce development support. · Conduct employability assessments and create individualized action plans that address barriers to employment. · Connect members to training, certification, and internship opportunities to improve job readiness. · Collaborate with CHWs to integrate employment support with broader SDoH needs such as housing, transportation, and childcare. · Develop and maintain partnerships with employers, HR departments, and workforce boards to identify job opportunities and advocate for member hiring. · Facilitate employer feedback loops to ensure job placements align with workforce needs. · Track and report member progress including training completion, job placements, certifications earned, and employment retention. · Support members post-placement to ensure long-term job stability and income growth.
· Maintain accurate case documentation and contribute to program reporting, evaluation, and improvement. · Promote an inclusive, culturally competent, and supportive environment for members pursuing career goals.
Qualifications Required:
· Bachelor’s degree in Workforce Development, Human Services, Social Work, Public Health, or related field OR equivalent combination of education and experience. · Experience in workforce development, career coaching, or employment services. · Strong knowledge of employer engagement strategies and community workforce resources. · Excellent interpersonal, communication, and advocacy skills. · Ability to travel statewide; must have a valid Indiana driver’s license, reliable personal vehicle, and auto insurance. · Proficiency with Microsoft Office Suite and workforce/case management documentation systems. · Ability to pass a drug test and background check. · FLU and COVID immunization.
Preferred: · Community Health Worker (CHW) Certification (or willingness to obtain within 6 months). · Experience working with Medicaid members or vulnerable populations. · Knowledge of Indiana’s workforce development systems, job boards, and employer networks. · Bilingual or multilingual skills.
Work Environment & Expectations
· Hybrid role: Combination of in-person community work, travel, and remote administrative tasks. · Travel across Indiana required; mileage reimbursed at the federal rate. · Flexible schedule required to accommodate youth and family needs.
Compensation & Benefits
· Competitive salary, commensurate with experience ($27 - $30 Hr). · Mileage reimbursement for required travel. · Health, dental, and vision insurance. · Paid time off, holidays, and sick leave.
· Professional development and training opportunities.
Diversity, Equity & Inclusion
PME is committed to building a diverse workforce that reflects the communities we serve. We strongly encourage applications from individuals with lived experience of employment challenges, diverse cultural backgrounds, and those who are bilingual.
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 26, 2025 Healthcare Job Title: Certified Community Health Worker (CHW)
Locations: Lake, Allen, St. Joseph, Marion, Tippecanoe, Delaware, Vanderburgh, and Jefferson Counties
Organization:
Professional Management Enterprises (PME) is a Minority-owned business dedicated to delivering innovative workforce solutions and community-based services. With a strong focus on equity and inclusion, PME partners with healthcare providers, government agencies, and community organizations to remove barriers and strengthen systems of care. Our mission is to empower individuals and families, creating pathways to healthier, more stable futures.
Position Summary
We are seeking Certified Community Health Workers (CHWs) (or those willing to obtain certification within six months) to join our team in targeted Indiana counties. CHWs will work closely with individuals, families, and community partners to address healthcare and social service needs. This role requires empathy, compassion, and a strong commitment to helping others overcome barriers; whether medical, social, or economic.
This is a remote position with at least 50% of time spent on the road, covering assigned regions within the counties listed. CHWs will use electronic health records and other digital tools to document activities, track progress, and coordinate care.
Key Responsibilities
Build trusting, respectful relationships with members to provide support, encouragement, and advocacy.
Conduct outreach, home visits, and community-based interactions to connect members with healthcare, social services, and workforce opportunities.
Assist members in navigating the healthcare system, including scheduling appointments, accessing insurance benefits, and understanding care plans.
Address social determinants of health (SDOH) such as food insecurity, housing instability, transportation, and employment barriers.
Support members with chronic conditions, disabilities, or other health concerns by coordinating care and identifying needed accommodations.
Document all interactions and interventions in electronic records accurately and promptly.
Collaborate with healthcare providers, social service agencies, and other community partners.
Provide culturally sensitive support, encouraging empowerment and self-advocacy among members.
Maintain compliance with HIPAA and confidentiality standards.
Cover assigned regions within counties, ensuring accessibility to members in the area.
Qualifications Required:
High school diploma or equivalent.
Experience navigating healthcare, social services, or related fields (including lived experience).
Demonstrated compassion, empathy, and ability to connect with people from diverse backgrounds.
Strong communication, organizational, and problem-solving skills.
Proficiency with computers and electronic record systems.
Knowledge of HIPAA regulations and commitment to confidentiality.
Ability to travel within assigned region; valid driver’s license and reliable vehicle required (mileage reimbursed).
Ability to pass a drug test and background check.
FLU and COVID immunization.
Preferred:
Community Health Worker (CHW) Certification (or willingness to obtain within 6 months).
Experience in care coordination, case management, or social services navigation.
Knowledge of Medicaid benefits, community based and healthcare supports, and Indiana’s Medicaid landscape
Experience working with Medicaid members, low-income populations, or individuals experiencing socio-economic instability.
Bilingual or multilingual skills.
Work Environment & Expectations
Remote-based role, with frequent travel in assigned regions.
At least 50% of work performed on the road or in the community.
Flexible schedule may be required to meet member needs (occasional visits outside of office hours).
Compensation & Benefits
Hourly rate: $23–$27, based on experience and certification.
Opportunities for professional development and CHW certification support.
Mileage reimbursement for work-related travel.
Mileage reimbursement for required travel.
Health, dental, and vision insurance.
Paid time off, holidays, and sick leave.
Professional development and training opportunities.
Diversity, Equity & Inclusion
PME strongly encourages applications from individuals who have overcome socioeconomic barriers, as well as applicants from minority backgrounds and those who are bilingual. We value diverse perspectives and believe lived experience enhances our team’s ability to support the communities we serve.
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 18, 2025 Healthcare Position Name: Grievance and Appeals Nurse
Location: Must Reside in Indiana, designated remote work position
Hours: Monday-Friday 8-5pm OR
Tuesday - Saturday (Saturday's are half days)
4 (9HR shifts) 7am-5:00pm
8am-6:00pm
9am-7:00pm
Pay $90,000k health, dental, and vision offered. 401k available. 80 hours of PTO and paid holidays
Job Description
Responsible for investigating and processing the most complex grievances and appeals requests from members and providers.
Primary duties may include, but are not limited to:
Conducts investigations and reviews of member and provider medical necessity appeals.
Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity.
Extrapolates and summarizes medical information for medical director, consultants and other external review.
Prepares recommendations to either uphold or deny appeal and forwards to Medical Director for approval.
Ensures that appeals and grievances are resolved timely to meet regulatory timeframes.
Documents and logs appeal/grievance information on relevant tracking systems and mainframe systems.
Generates written correspondence to providers, members, and regulatory entities.
Utilize leadership skills and serves as a subject matter expert for appeals/grievances/quality of care issues and is a resource for clinical and non-clinical team members in expediting the resolution of outstanding issues.
Requirements
Requires 2 years of experience in a managed care healthcare setting; or any combination of education and experience, which would provide an equivalent background.· Behavioral Health experience
Current active unrestricted RN license to practice as a health professional within the scope of licensure in IN·
Requires strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
MCG (Milliman Care Guidelines) experience
CMCN (Certified Managed Care Nurse) certification strongly preferred
AS required/BS in Nursing preferred.
Salary Description
90,000 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 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 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 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.