Medical Billing & Accounts Receivable Representative

CVS Health; San Juan (PR); On-site; USD 23,000 - 35,000; Full time

Job summary

CVS Health Specialty Pharmacy seeks a Medical Billing & Accounts Receivable Representative to ensure timely, accurate billing and follow-up for claims. You will work with patients, physicians, and insurers in a fast‑paced, team‑oriented setting.

The role requires 1+ year healthcare insurance experience, proficiency with Excel/Outlook/Word, and bilingual English/Spanish communication. 40 hours weekly; base pay $17.00–$25.65 per hour with strong benefits.

Qualifications

• 1+ years of healthcare insurance experience.
• Experience with Excel, Outlook and Word.
• Bilingual in English and Spanish with fluent communication.

Responsibilities

• Create and submit medical claims to insurance companies within guidelines.
• Validate coverage and eligibility prior to claim billing.
• Resolve insurance problems and patient issues impacting billing.
• Maintain notes detailing actions taken to resolve issues.
• Follow company compliance and update AR/CVS systems accordingly.
• Communicate with patients, providers, and payers to resolve accounts.

Skills

Bilingual English/Spanish

Communication

Education

High School Diploma or GED

Tools

Excel

Outlook

Word

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

CVS Health Specialty Pharmacy has an opportunity available for a full-time Medical Billing & Accounts Receivable Representative. As a Medical Billing & Accounts Receivable Representative, you will ensure timely and accurate billing and follow-up for outstanding claims while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. As part of the billing and reimbursement team, you will work in a fast paced and team focused environment to ensure timely and accurate billing to insurance providers.

We will support you by offering all the tools and resources you need to be successful in a collaborative team based environment.

The key responsibilities of the Medical Billing & Accounts Receivable Representative are:

• Creating and submitting medical claims to insurance companies within timely filing and ensuring accuracy within payer guidelines and preferred bill methods (i.e., 837, website, spreadsheets, and CMS-1500).
• Validating coverage and eligibility prior to claim billing.
• Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
• Maintaining supporting and chronological notes that detail action taken to resolve billing edits.
• Maintain updated information within the necessary AR/CVS systems that are in accordance with the company policy. Following the company compliance regulations.
• Being an effective communicator with patients, providers, and insurance agents to resolve account issues.
• Research information on provider portals.
• Ensure that payer guidelines are being met.
• Ability to spot inaccuracies or inconsistencies in medical documentation and ensure precision.
• Following up on unpaid claims and initiating appeals for denied ones within standard payer guidelines.
• Resolve issues with nonpayment of invoices due to insurance problems that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors.
• Research and respond by telephone, via the internet and in writing to insurance companies and governmental payers regarding collection issues and problems
• Contact patients, physician's offices, government agencies, and insurance companies for claim resolution.
• Contact patients, physician's offices, or payer entities to secure necessary documentation required for claim reimbursement.

Required Qualifications:

• 1+ years Healthcare Insurance experience.
• Experience using Microsoft Office products specifically Excel, Outlook and Word.
• Bilingual in English and Spanish, with the fluent ability to communicate effectively in both written and verbal formats.

Preferred Qualifications:

• Insurance billing or collections experience
• Customer service in a healthcare and team environment
• Attention to detail
• Ability to multitask and meet deadlinesAbility to utilize problem solving skills
• Ability to communicate with clientele in a professional manner

Education:

• Verifiable High School Diploma or GED required.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $25.65

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 11/13/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.