Sales Rep - Medicare Authorized Representative Company: Triple-S Salud Job Location (Short): Aguadilla, PR Posting Start Date: 8/10/26 At Triple-S, we are committed to providing meaningful job ...
Sales Rep - Medicare Authorized Representative Company: Triple-S Salud Job Location (Short): Aguadilla, PR Posting Start Date: 8/10/26 At Triple-S, we are committed to providing meaningful job ...
Sales Rep - Medicare Authorized Representative Company: Triple-S Salud Job Location (Short): Hatillo, PR Posting Start Date: 8/10/26 At Triple-S, we are committed to providing meaningful job ...
Sales Rep - Medicare Authorized Representative Company: Triple-S Salud Job Location (Short): Hatillo, PR Posting Start Date: 8/10/26 At Triple-S, we are committed to providing meaningful job ...
PR · On-site
Review applicable local, Medicare and state regulations and file any necessary information with regulatory agencies, if appropriate. * Monitor and interpret regulatory changes impacting PBM ...
Quick apply
Sales Promoter
Bayamon, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join ...
Sales Promoter
Bayamon, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join ...
Sales Promoter
Hatillo, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join ...
New
Sales Promoter
Hatillo, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join ...
New
Enrollment Representative
Guaynabo, PR · On-site
Servimos a más de a más de 1 millón de asegurados en Puerto Rico, a través de nuestras líneas de negocios Medicare Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos ...
Enrollment Representative
Guaynabo, PR · On-site
Servimos a más de a más de 1 millón de asegurados en Puerto Rico, a través de nuestras líneas de negocios Medicare Advantage, Medicaid, Comercial, Vida y Propiedad & Contingencia. Construyamos ...
PR · On-site
$11.75 - $14.75/hr
Mínimo de dos años de experiencia en la asignación de DRG/APC para casos Medicare. * Bilingüe (Español & Inglés). * Dominio en Microsoft Office (Word, Power Point, Excel, Publisher) y en otros ...
Quick apply
PR · On-site
$11.75 - $14.75/hr
Mínimo de dos años de experiencia en la asignación de DRG/APC para casos Medicare. * Bilingüe (Español & Inglés). * Dominio en Microsoft Office (Word, Power Point, Excel, Publisher) y en otros ...
PR · On-site
Mínimo de dos años de experiencia en la asignación de DRG/APC para casos Medicare. * Bilingüe (Español & Inglés). * Dominio en Microsoft Office (Word, Power Point, Excel, Publisher) y en otros ...
Quick apply
PR · On-site
Mínimo de dos años de experiencia en la asignación de DRG/APC para casos Medicare. * Bilingüe (Español & Inglés). * Dominio en Microsoft Office (Word, Power Point, Excel, Publisher) y en otros ...
Director(a) De Formularios Y Medicamentos Especializados
San Juan, PR · On-site
$110 - $140/hr
Support the review of the Pharmacy sections of the Medicare Advantage BID and Commercial Policies documents to ensure that formulary strategies and benefit designs are accurately represented and ...
Director(a) De Formularios Y Medicamentos Especializados
San Juan, PR · On-site
$110 - $140/hr
Support the review of the Pharmacy sections of the Medicare Advantage BID and Commercial Policies documents to ensure that formulary strategies and benefit designs are accurately represented and ...
PR · On-site
$18 - $24/hr
Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * And all other duties assigned by the ...
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PR · On-site
$18 - $24/hr
Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * And all other duties assigned by the ...
Information Specialist
Guaynabo, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join ...
Information Specialist
Guaynabo, PR · On-site
We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses. Let's build healthier communities together, join ...
Director(a) De Gestión Laboral
San Juan, PR · On-site
$120 - $170/hr
Ensure compliance with all applicable federal, state, Center for Medicaid and Medicare Services (CMS), Medicare, Medicaid, Health Insurance Portability and Accountability Act (HIPAA), and ...
Director(a) De Gestión Laboral
San Juan, PR · On-site
$120 - $170/hr
Ensure compliance with all applicable federal, state, Center for Medicaid and Medicare Services (CMS), Medicare, Medicaid, Health Insurance Portability and Accountability Act (HIPAA), and ...
PR · On-site
$16.75 - $20.25/hr
... for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. 8. In addition, all other duties assigned by the manager and/or supervisor. Education:
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PR · On-site
$16.75 - $20.25/hr
... for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. 8. In addition, all other duties assigned by the manager and/or supervisor. Education:
Representante de Telemercadeo
$15.25 - $19/hr
Al atender a clientes potenciales de Medicare, debe asegurarse de cumplir con las regulaciones de los Centros de Servicios de Medicare y Medicaid (CMS) y las políticas y procedimientos de la unidad.
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Representante de Telemercadeo
$15.25 - $19/hr
Al atender a clientes potenciales de Medicare, debe asegurarse de cumplir con las regulaciones de los Centros de Servicios de Medicare y Medicaid (CMS) y las políticas y procedimientos de la unidad.
PR · On-site
$18 - $24/hr
Cumple todas las directrices establecidas por los Centros de Medicare y Medicaid (CMS) y las directrices establecidas por otros organismos reguladores, cuando procede. * Y todas las demás funciones ...
Quick apply
PR · On-site
$18 - $24/hr
Cumple todas las directrices establecidas por los Centros de Medicare y Medicaid (CMS) y las directrices establecidas por otros organismos reguladores, cuando procede. * Y todas las demás funciones ...
Pharmacy Technician
$17.25 - $20.75/hr
Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties are ...
Quick apply
Pharmacy Technician
$17.25 - $20.75/hr
Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. * In addition, all other duties are ...
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
Quick apply
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
Quick apply
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
Quick apply
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
Quick apply
PR · On-site
Al momento de evaluar y durante sus intervenciones, vigilar por que el paciente a su cargo esté en cumplimiento con los criterios de elegibilidad del Programa Medicare. * Verificar que cada paciente ...
Medicare information
What is a Medicare?
A Medicare job typically involves working with the federal health insurance program that provides coverage for seniors and certain individuals with disabilities. Roles in this field can include customer service representatives, claims processors, billing specialists, and Medicare advisors. Responsibilities often include helping beneficiaries understand their coverage, processing claims, ensuring compliance with regulations, and assisting with enrollment. Many Medicare jobs are found in healthcare companies, government agencies, or insurance providers.
What are the key skills and qualifications needed to thrive in the Medicare position, and why are they important?
To thrive in a Medicare Specialist role, a deep understanding of Medicare regulations, claims processing, and health insurance fundamentals is essential, often requiring a background in healthcare administration or a related field. Familiarity with billing software, claims adjudication systems, and relevant certifications such as Certified Medical Reimbursement Specialist (CMRS) are highly valuable. Strong attention to detail, analytical thinking, and effective communication skills help distinguish top performers. These competencies ensure accurate claim handling, regulatory compliance, and positive interactions with providers and beneficiaries.
What are common challenges faced by Medicare specialists, and how are they addressed on the job?
Medicare Specialists often encounter challenges related to keeping up with frequently changing regulations and managing complex claims issues. Staying current with updates requires ongoing training and close attention to industry bulletins. Handling denials or appeals can be demanding, but most teams provide collaborative support and access to resources for resolving difficult cases. Effective time management and clear communication with both beneficiaries and healthcare providers help streamline processes and ensure compliance. Many organizations also offer opportunities for skill development to help specialists adapt to evolving policies.
What are popular job titles related to Medicare jobs in Puerto Rico?
For Medicare jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Medicare jobs in Puerto Rico look for?
The top searched job categories for Medicare jobs in Puerto Rico are:
Full-time
This job post has expired today. Applications are no longer accepted.
Job description
Sales Rep - Medicare Authorized Representative
Company: Triple-S Salud
Job Location (Short): Aguadilla, PR
Posting Start Date: 8/10/26
At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
Responsible for effectively promoting our managed care products designed for persons eligible for Medicare. The Medicare Authorized Representative will grow membership through various sales and marketing initiatives, including conducting face-to-face sales enrollment meetings, communities, and providers education sessions to existing and potential members. Required to follow all company and CMS rules and regulations, and will be monitored regarding volume, quality, accuracy, and demeanor.
ESSENTIAL FUNCTIONS
EDUCATION
EXPERIENCE
LICENSES AND CERTIFICATIONS
COMPETENCIES
It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.
Company: Triple-S Salud
Job Location (Short): Aguadilla, PR
Posting Start Date: 8/10/26
At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
Responsible for effectively promoting our managed care products designed for persons eligible for Medicare. The Medicare Authorized Representative will grow membership through various sales and marketing initiatives, including conducting face-to-face sales enrollment meetings, communities, and providers education sessions to existing and potential members. Required to follow all company and CMS rules and regulations, and will be monitored regarding volume, quality, accuracy, and demeanor.
ESSENTIAL FUNCTIONS
- Responsible for managing an assigned territory to promote and sell TSA products.
- Maintain and establish positive relationships with providers and organizations in the community.
- Follow procedures and timeliness when submitting daily in-home visits reports to Sales Coordinator.
- Report daily production as agreed with Supervisor and Manager.
- Responsible for ensuring the completeness, quality and eligibility criteria of member's application to meet Enrollment Requirements.
- Contact or follow up on current members in order to obtain customer satisfaction.
- Responsible for effectively communicate benefits and enrollment information to potential members; especially those members with special needs due to physical and/and or mental disabilities.
- Ensure all completed applications are submitted within required time frames; complete administrative paperwork to maintain smooth operations and log activities.
- Identify groups, social services agencies and any other community organization to promote products and services.
- Acts as liaison with community advocacy groups that impacts our target population.
EDUCATION
- Bachelor's Degree in Business Administration
EXPERIENCE
- Bachelor's degree in Business Administration and/or Health, preferable, with 1 to 3 years of related experience preferable in the Health Insurance Industry, or associates Degree (60-64 college credits) with 3 to 5 years of related experience preferable in the Health Insurance Industry.
- Or at least 5 years of this work experience in lieu of.
- DOI - Health and Disability License (or ability to request one within first 15 days of employment).
LICENSES AND CERTIFICATIONS
COMPETENCIES
- Action Oriented
- Collaborates
- Manages Ambiguity
- Instills Trust
- Customer Delight
It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.