Contract Jul 28, 2025 Healthcare This is an entry level position in the Appeals Department that reviews, analyzes and processes non-complex preservice and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (Part A & B) related to clinical and non-clinical services, quality of service, and quality of care issues to include executive and regulatory grievances.
Job Title: SCA Appeals Rep I
Location: Remote US
Hours: M-F 8am-5pm (During training, hours will be 8:30 EST to 5:00 EST (approximate). All training will be virtual. After training, we have a flex start window between 6:00 AM EST time and 10:00 AM EST time.)
Primary duties may include, but are not limited to:
Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language. Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing and/or medical staff for review. The grievance and appeal work is subject to applicable accreditation and regulatory standards and requirements. As such, the analyst will strictly follow department guidelines and tools to conduct their reviews. Analyzes and renders determinations on assigned non-complex grievance and appeal issues and completion of the respective written communication documents to convey the determination. Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information. The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments.
Requirements
Requires a High school diploma or GED; up to 2 years’ experience working in grievances and appeals, claims, or customer service or any combination of education and/or experience which would provide an equivalent background.
Familiarity with medical coding and medical terminology, demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, all the company's internal business processes, and internal local technology strongly preferred.
Contract Jul 25, 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) (Spanish/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)(Spanish/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 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 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 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.
