***Positions posted by El Comeback are done on behalf of companies that we support in their search for candidates.***

Medical Billing Operations Lead

Location: San Juan, Puerto Rico
Type: Full-Time
Schedule: Flexible / Remote-Friendly
Salary: $30,000–$40,000 (starting)
Specialty: OB/GYN
Payers: ASES, Triple-S, MCS, Medicare                    Certification: Company-paid AAPC CPC                                           Bonus: Performance-based

About the Opportunity

Our client is a growing medical billing company based in Puerto Rico that specializes exclusively in OB/GYN revenue cycle management. The company uses modern AI-powered billing software to automate claim submission, reduce denials, and improve results for healthcare providers.

This is a ground-floor opportunity where the selected candidate will become the first Operations hire and play a key role in helping build processes and support the growth of the business. As the company grows from its first client to multiple clients, the role, responsibilities, and compensation will grow as well.

The company is looking for a bilingual, detail-oriented professional who is excited about building something and improving operations in a growing organization.

Compensation & Benefits

- The starting salary ranges between $30,000 and $40,000 annually ($14–$19 per hour), which is competitive for the market.

- As the company grows and additional clients are onboarded, compensation increases:

- At 3–5 clients, compensation may increase to approximately $38,000–$46,000 annually ($18–$22 per hour).

- With 2+ years of experience and 5+ clients managed, compensation may reach approximately $45,760–$54,080 annually ($22–$26 per hour) and become eligible for performance bonuses.

What they Pay For: 

• AAPC annual membership (~$222/year)

• CPC certification exam fees (~$499 for 2 attempts)

• All coding books and study materials

• Performance bonus of 1–2% on collections above monthly target
• Flexible/remote work schedule — results matter, not hours

What You Will Do

- You will own the end-to-end billing cycle for our OB/GYN clients. Day to day this means:

• Enter and verify patient insurance eligibility before visits (ASES, Triple-S, MCS, Medicare Advantage).
• Review clinical documentation and assign accurate CPT and ICD-10 codes for OB/GYN encounters.
• Submit clean claims daily through our billing platform (CollaborateMD).
• Track claim status and follow up on unpaid or pending claims.                       
• Manage and appeal denied claims — write appeal letters, provide supporting documentation.
• Post payments and reconcile EOBs / ERAs. 
• Generate weekly and monthly reports for each client showing collections, denials, and A/R aging.
• Learn our software deeply and help build SOPs (standard operating procedures) as we grow. 
• Communicate directly with doctor offices to resolve documentation gaps or coding questions.

Required Qualifications

• Fully bilingual — Spanish and English (written and spoken).
• 2+ years of experience in medical billing, healthcare administration, or insurance in Puerto Rico.
• Hands-on experience with at least one of the following portals: ASES/Vital, Triple-S, MCS, or Medicare Advantage.
• Strong attention to detail.
• Comfortable learning and adapting to new software quickly.

Preferred Qualifications

• AAPC CPC, CPB, or similar medical coding/billing certification.
• Experience with OB/GYN billing, including maternity packages or delivery coding.
• Experience with CollaborateMD, Tebra/Kareo, or similar billing platforms.
• Experience working in a medical billing company or revenue cycle management environment.

***El Comeback is a non-profit program from ConPRmetidos that attracts and retains professional talent for Puerto Rico-based jobs. Register at elcomebackpr.org/registration-form to get matched with professional opportunities on the island.***