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Medicare Jobs in Puerto Rico (NOW HIRING)

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 ...

PR · On-site

$13.75 - $16.50/hr

Supervisa a la Gerente de MICASS y los procesos conducentes a la obtención y mantenimiento de las licencias, certificación de Medicare y/o acreditaciones de la organización. * Tiene bajo su cargo ...

PR · On-site

$13.75 - $16.50/hr

Supervisa a la Gerente de MICASS y los procesos conducentes a la obtención y mantenimiento de las licencias, certificación de Medicare y/o acreditaciones de la organización. * Tiene bajo su cargo ...

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 ...

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 ...

PR · On-site

Demonstrates sound knowledge of reimbursement and billing practices for Medicare, Medicaid, managed care, charity care and other third-party payers * Demonstrates cultural sensitivity * Maintains ...

PR · On-site

Your expertise will directly support our mission of delivering high-quality, patient-centered care while optimizing clinical outcomes and reimbursement in alignment with Medicare and Medicaid ...

PR · On-site

Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. 12. And all other duties assigned by ...

Claims Examiner

Guaynabo, PR · On-site

$21/hr

  • Retirement

  • PTO

Medicare, Medicaid, commercial insurance, or managed care ; Clinical documentation review Proficiency with: ICD-10-CM ; CPT ; HCPCS ; Medical terminology ; Anatomy and physiology ; EHR systems (such ...

PR · On-site

Cumple con todas las guías establecidas por los Centros de Medicare y Medicaid (CMS) y otras agencias reguladoras aplicables. * Realiza todas las demás tareas asignadas por el gerente y/o ...

PR · On-site

  • Medical

  • Retirement

  • PTO

The Clinical Screener provides general information and non-clinical guidance to enrollees, including, but not limited to, Medicare, Medicaid, Commercial, and Government Health Plan enrollees, over ...

PR · On-site

  • Medical

  • Retirement

  • PTO

The Clinical Screener provides general information and non-clinical guidance to enrollees, including, but not limited to, Medicare, Medicaid, Commercial, and Government Health Plan enrollees, over ...

PR · On-site

  • Medical

  • Retirement

  • PTO

The Clinical Screener provides general information and non-clinical guidance to enrollees, including, but not limited to, Medicare, Medicaid, Commercial, and Government Health Plan enrollees, over ...

PR · On-site

  • Medical

  • Retirement

  • PTO

The Clinical Screener provides general information and non-clinical guidance to enrollees, including, but not limited to, Medicare, Medicaid, Commercial, and Government Health Plan enrollees, over ...

PR · On-site

PBM and/or Medicare experience, preferred. PROFESSIONAL COMPETENCIES Knowledge: * Expert Knowledge in MS Office, mainly Excel and Power BI. * Basic SQL knowledge, preferred. * Fully bilingual English ...

Showing results 21-40

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:

Infographic showing various Medicare job openings in Puerto Rico as of August 2026, with employment types broken down into 93% Full Time, and 7% Contract. Highlights an 100% In-person job distribution.

Enfermero de Infusión(Contratista) - Region Este

Alivia Health

PR • On-site

Contractor

Re-posted 17 days ago


Job description

Region Este: Naguabo, Las Piedras, Humacao / San Lorenzo y Caguas / Arroyo Patillas

El contratista de Enfermería de Infusión para visitas al Hogar es responsable de administrar terapias de infusión en el hogar de los pacientes de Alivia Infusion Services. Realiza evaluaciones clínicas para determinar la elegibilidad y continuidad del tratamiento. Administra terapias intravenosas, educa al paciente y su familia, y documenta conforme a estándares clínicos, regulatorios y de acreditación (ACHC,CMS y Departamento de Salud de Puerto Rico).


Deberes y Responsabilidades principales:

  • Realizar evaluaciones, y seguimientos de pacientes que son referidos al Programa de Infusión en el Hogar, utilizando los criterios de admisión aprobados por AIS.
  • 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 tenga orden médica, autorización del plan médico y, posteriormente, realizar una visita de admisión en un máximo de veinticuatro (24) horas de acuerdo con el tratamiento del paciente.
  • Ofrecer seguimiento del examen físico de cada paciente, incluyendo, pero sin limitarse a, signos vitales, estimado físico, mental, sicosocial, revisión de medicamentos y dieta.
  • Asegurarse de tener kit de profilaxis disponible para uso en cada visita a los pacientes en caso de activar las guías ante una reacción adversa.


Requsitos:

  • Bachillerato en Enfermería de universidad acreditada.
  • Licencia vigente de Enfermero/a en Puerto Rico.
  • Licencia de conducir valida en Puerto Rico y disponibilidad de vehículo de motor
  • Mínimo de 2 años de experiencia en servicios de Home Health, Infusión o cuidado agudo. Preferiblemente en entorno domiciliario.