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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 27, 2025 Healthcare Paralegal III to assist Legal Affairs Department in scheduling, completing & maintaining regulatory filings required by state & federal agencies in accordance with statutory & contractual requirements; assist compliance officials in scheduling, completing & maintaining filings related to compliance with healthcare related statutory or programmatic requirements.
Work Schedule: M-F 8a-5p or 9a-6p PST
Work Location: Remote US
Pay: $34.00 hourly
Essential Functions:
Draft and prepare regulatory filings and other documents required by state and federal agencies.
Assist in responding to state audits and examinations.
Draft and maintain a variety of corporate documents including but not limited to company formation documents (e.g., name reservations, articles, bylaws, operating agreements), dissolutions, conversions, board and shareholder consents, resolutions, meeting minutes, foreign qualifications, fictitious business name filings, intercompany agreements, biographical affidavits, license renewals, annual reporting (assist with registered agent filings).
Assist the Deputy General Counsel with the preparation of holding company filings.
Research statutes and regulations for the many various jurisdictions, with an emphasis on health maintenance organizations, corporations, and LLCs, and holding companies.
Maintain multiple tracking charts (subsidiaries, officers and directors, intercompany agreements, licenses).
Provide overall support for health plans, health plan attorneys and staff.
Provide support for new business and proposal teams, as needed.
Provide support for mergers and acquisitions team, as needed.
Assist with the maintenance of intellectual property (trademarks, logos, etc.); interact with trademark counsel and Marketing team.
Organize and maintain all substantive work products including correspondence, documents, filings, etc. in electronic file storage system.
Research historical and archived Legal department records as needed.
Possess a professional demeanor and the ability to establish a good rapport with state regulators.
Assist with other legal matters/provide general legal support.
Coordinate remote notarizations for executives and directors with in-house notaries.
Coordinate activities between regulators and Legal Affairs Department.
Must Have Skills:
5-7 years’ experience as a paralegal, with preference to have at least 3 years of managed healthcare experience with an understanding of Medicare, Medicaid, and Marketplace (multistate experience preferred).
Must be proficient with Microsoft Office, including Outlook, Word, Teams, and Excel; document management systems (iManage if possible), Westlaw, Edge, or Chrome, SharePoint sites.
Highly attentive to detail; able to handle large amounts of paperwork for a busy office; excellent organizational and time management skills; clear, concise, and logical writing style; interest in healthcare and healthcare law.
Strong analytical, problem-solving, communication, interpersonal and research skills. Accountable and dependable.
Knowledge of NAIC regulations and guidelines, state insurance departments’ websites and filing portals.
Required Education:
Bachelor’s Degree or equivalent experience
Required Experience:
5+ years’ experience
Required Licensure/Certification/Associations:
Paralegal Certificate or equivalent
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 24, 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 Jun 24, 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
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Contract Jun 24, 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 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.