Contract Jul 17, 2025 Healthcare Job Title: Clinical Review Nurse I
Location: Remote – Work From Home
Schedule: Monday through Friday, 8:30 AM – 5:00 PM
Job Summary:
We are seeking a detail-oriented and compassionate Clinical Review Nurse to join our team in a remote, full-time capacity. In this role, you will be responsible for conducting clinical reviews of medical claims to determine whether the services provided meet the benefit criteria of the member's health plan. The ideal candidate will use sound clinical judgment, adhere to medical policy, and ensure compliance with established guidelines to support appropriate and timely claims determinations.
Key Responsibilities:
Review and evaluate clinical information on submitted claims for medical necessity, appropriateness, and alignment with established medical policy and criteria.
Make determinations based on clinical judgment, policy guidelines, and benefit coverage.
Collaborate with physicians, providers, and other healthcare professionals as needed to gather additional information.
Document all decisions and clinical rationale clearly and accurately in the appropriate systems.
Ensure compliance with applicable regulatory standards and organizational policies.
Maintain current knowledge of medical guidelines and benefit structures.
Qualifications:
Required:
Associate’s Degree in Nursing (ASN or ADN).
Minimum of 1 year of clinical experience (hospital, outpatient, or other direct patient care setting).
Current, unrestricted RN license in good standing in your state of residence.
Strong attention to detail, critical thinking, and decision-making skills.
Proficient in using computer systems and electronic documentation platforms.
Preferred:
Bachelor’s Degree in Nursing (BSN).
Experience in medical claims review, utilization management, or case management.
Ability to interpret and apply medical policy, clinical criteria, and health plan benefits.
Strong written and verbal communication skills, with the ability to clearly articulate clinical decisions.
Additional Information:
Work Environment: 100% Remote – must have a reliable internet connection and appropriate home office setup.
Hours: Monday–Friday, 8:30 AM–5:00 PM (no weekends or holidays required).
Competitive compensation and benefits package available.
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 Jul 17, 2025 Call Center Job Title: Customer Service Representative (Outbound)
Location: Indianapolis, IN (Remote)
Pay: $14hr
A customer service representative, or CSR, will act as a liaison, provide services information, and resolve any emerging problems that our customer accounts might face with accuracy and efficiency. The best CSRs are genuinely excited to help customers. They’re patient, empathetic, and passionately communicative. They love to talk. Customer service representatives can put themselves in their customers’ shoes and advocate for them when necessary. Problem-solving comes naturally to customer care specialists. They are confident at troubleshooting and investigate if they don’t have enough information to resolve customer complaints. The target is to ensure excellent service standards, respond efficiently to customer inquiries and maintain high customer satisfaction.
Each representative will be a part of an incentive program that pays out weekly (in addition to base pay)
Must be able to work a fixed 8 hr shift between 8am-8pm
Candidate must reside in Indiana
All equipment will be provided to each representative to work remotely
Requirements:
Manage large amounts of outgoing calls to welcome members
Identify and assess customers’ needs to achieve satisfaction
Build sustainable relationships and trust with customer accounts through open and interactive communication
Provide accurate, valid, and complete information by using the right methods/tools
Meet personal/customer service team targets and call handling quotas
Handle customer complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolution.
Keep records of customer interactions, process customer accounts and file documents
Follow communication procedures, guidelines, and policies
Take the extra mile to engage customers
Ability to create and maintain a professional remote work environment/area
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 Jul 14, 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 Jul 14, 2025 Information Technology Job Title: Business Analyst II
Location: Remote (Indiana)
Hours: M-F : 8AM to 5PM EST. Will work remote and will may require to come in if needed in the future.
***Requires a BS/BA degree & Must have 3-5 years of experience)***
Job Description:
We are looking for a skilled BA/Automation Tester with a strong background in the payments domain to join our team on a contractual basis. The ideal candidate will have extensive experience in Business Requirement Analysis, Python scripting, AWS Glue ETL Validation, and Power BI Testing. You will be essential in ensuring the quality and reliability of our payment systems through detailed testing and validation processes.
Key Responsibilities:
Business Analysis:
Collaborate with stakeholders to gather and analyze requirements related to payment systems.
Document functional specifications and technical requirements to guide development and testing processes.
Automation Testing:
Design, develop, and execute automated test scripts using a Test Automation Framework with Python and other required tools to ensure robust and scalable solutions.
Perform regression testing and identify, document, and track defects to closure.
Collaborate with development teams to resolve identified issues and improve system performance.
AWS Glue ETL Validation:
Validate and test ETL processes and data pipelines in AWS Glue to ensure data integrity and accuracy.
Conduct comprehensive testing of data transformations, data flow, and data mappings.
Power BI Testing:
Test Power BI dashboards and reports for accuracy, reliability, and performance.
Validate data visualizations to ensure alignment with business requirements and user expectations.
Payments Domain Expertise:
Apply expertise in the payments industry to enhance test coverage and scenario planning.
Stay updated with industry trends and regulations to ensure compliance and mitigate risks.
Required Skills and Qualifications:
Proven experience as a Business Analyst and Automation Tester in the payments domain.
Proficiency in Python for scripting and automation testing.
Hands-on experience with AWS Glue ETL processes and validations.
Familiarity with Power BI testing and validation practices.
Strong understanding of data analysis and data validation techniques.
Excellent communication and documentation skills.
Ability to work collaboratively in a fast-paced, dynamic environment.
Strong problem-solving skills and attention to detail.
Preferred Qualifications:
Experience with other ETL tools and technologies.
Certifications related to AWS, Power BI, or software testing.
Familiarity with agile methodologies and tools like JIRA.
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 Jul 6, 2025 Information Technology Title: Deskside Support Technician
Hours: Mon-Fri 8am-5pm
Pay: $19hr
Job Summary:
The Deskside Support Technician provides on-site technical support for hardware, software, and peripheral devices across multiple client locations. This role involves troubleshooting, installing, maintaining, and repairing IT equipment and systems while delivering excellent customer service. The technician acts as the primary point of contact for technical support, performing Tier 1 duties and escalating more complex issues when necessary.
Essential Functions:
Install, maintain, and repair computer systems, hardware components, and peripheral equipment.
Provide Tier 1 technical support and assist with Tier 2 support as needed.
Escalate unresolved or high-impact issues promptly according to escalation procedures.
Ensure timely and accurate updates in client ITSM tools and service management systems.
Process warranty claims and support vendor compliance for hardware replacements.
Coordinate with internal teams and third-party vendors to resolve service issues.
Uphold a high level of customer satisfaction through proactive support and communication.
Follow all client security protocols, policies, and data integrity procedures.
Interact professionally with clients, users, and other team members on-site and remotely.
Maintain professional appearance and behavior.
Maintain attendance and punctuality standards in line with company expectations.
Perform other duties as assigned by management.
Required Education, Experience, and Certifications:
High school diploma or equivalent required; Associate’s or Bachelor’s degree in a related field preferred.
1–3 years of relevant technical support or IT service experience preferred (equivalent education may substitute).
Experience with Microsoft Windows operating systems and Office Suites.
Familiarity with Active Directory, imaging software, and enterprise support tools.
Client-specific certifications may be required based on project or location.
Skills and Abilities:
Strong verbal and written communication skills.
Ability to explain technical concepts clearly to non-technical users.
Effective interpersonal skills with a customer-first attitude.
Strong organizational skills and attention to detail.
Ability to work independently and as part of a cross-functional team.
Demonstrated problem-solving ability in a fast-paced environment.
Physical and Work Environment Requirements:
Must be able to lift and transport equipment and boxes weighing up to 75 lbs.
Ability to stand, walk long distances, and climb stairs throughout the workday.
Must be capable of kneeling, crouching, and crawling when required.
Prolonged periods of computer use required.
Must be able to travel to client sites; some overnight travel may be necessary.
Work is typically performed in a professional office or client site environment.
Tools and Equipment Used:
Desktop and laptop computers
Communication headset
Company vehicle (if provided)
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 Jul 1, 2025 Call Center Professional Management Enterprises is seeking a Customer Care Representative to join our call center team! As a Customer Care Representative, you will act as a trusted advisor and educator on health care related inquiries. You will guide our customers to a better healthcare experience, working every day to make healthcare easy with the service you provide.
Job Title: Customer Care Representative (Burmese/English)
Location: Indianapolis, Indiana (Remote) **Must be an Indiana Resident**
Pay: (Weekly Pay)
Work Hours: Monday-Friday, 10am - 6:30pm
Duties and Responsibilities:
Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
Analyzes problems and provides information/solutions.
Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
Thoroughly documents inquiry outcomes for accurate tracking and analysis.
Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
Researches and analyzes data to address operational challenges and customer service issues.
Provides external and internal customers with requested information.
Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
Uses computerized systems for tracking, information gathering and troubleshooting.
Requires limited knowledge of company services, products, insurance benefits, provider contracts and claims.
Seeks, understands and responds to the needs and expectations of internal and external customers.
Required to meet department goals.
Skills:
Experience in customer service is a plus
Bilingual (Burmese/English)
Ability to navigate multiple computer screens at a time.
Ability to provide quality customer service while multi-tasking is a plus.
Requirements:
Requires a HS diploma or equivalent; up to 1 year of previous experience in an automated customer service environment; or any combination of education and experience, which would provide an equivalent background.
Must have a private area to work closed off from others.
Can not be responsible for minors or be a primary caretaker for another person during working hours.
Must live within a 50 miles radius of Indianapolis, Indiana
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.
Contract Jun 24, 2025 Call Center 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 Jun 16, 2025 Administrative Job Title: Shipping/Receiving Clerk
Location: 401 N. Shadeland, Indianapolis, IN 46219
Hourly Rate: $21.62/hr
Job Type: Full-Time
Shift: Monday – Friday, 7:00 AM – 3:30 PM
Position Overview:
Professional Management Enterprises is seeking a dependable and safety-conscious Shipping & Receiving Clerk to join our team in Indianapolis, IN. This position plays a key role in supporting inventory control operations including receiving and inspecting incoming and outgoing shipments, verifying and recording received items, unpacking and organizing materials, loading and unloading trucks, and operating pallet jacks or other equipment.
Responsibilities:
Verify and record incoming and outgoing shipments, ensuring accuracy in documentation and shipment quantities.
Load and unload pallets, trucks, and storage areas safely and efficiently.
Operate automated mail sorting equipment in accordance with standard operating procedures.
Perform general inventory control tasks such as labeling, sorting, and staging items for internal processing, archival, and shipment.
Maintain accurate records of inventory locations and movements using inventory management systems including barcode scanners, or logs.
Maintain cleanliness and safety of work areas and equipment.
Follow all safety and security guidelines and company protocols.
Organize and label boxes according to established protocols to ensure easy retrieval and tracking.
Qualifications:
• High school diploma or equivalent.
• Experience operating manual or electric pallet jacks required.
• Previous warehouse or material handling experience preferred.
• Ability to lift and move up to 50 lbs. regularly.
• Good communication and teamwork skills.
• Strong attention to detail and ability to follow directions.
• Comfortable working in a physically demanding and fast-paced environment.
Professional Management Enterprises, inc. is an Equal Opportunity Employer and is committed to diversity in the workplace. We encourage all qualified individuals, including those with diverse backgrounds and those with disabilities, to apply.
