Healthcare Operations Specialist: Claims & Compliance

Cloudstaff Philippines Inc.; Cebu City; On-site; PHP 279,000 - 558,000; Full time

Benefits offered by this job

HMO Coverage

Annual Performance Review with Salary

Employee Share Units program

Cloudstaff Dream Points

Company-provided PC/Laptop and fiber

Weekly office perks: Free Coffee,Meals

Mental Wellness EAP

International career growth

In-house psychiatrist

Flexible leave credits

VIP lounge and game rooms

Referral incentives

Job summary

Cloudstaff Philippines Inc. is seeking an experienced US Healthcare Operations Associate to support day-to-day health operations, ensuring accurate processing of healthcare transactions and regulatory compliance.

You will collaborate with internal teams, monitor SLAs, and uphold HIPAA standards to deliver high-quality service to US-based clients. This role emphasizes attention to detail, analytical thinking, and stakeholder management, with growth opportunities and comprehensive benefits within

Qualifications

• Bachelor's degree preferred.
• 2–5 years of experience in US healthcare operations.
• Experience in claims processing, prior authorization, eligibility verification, and revenue cycle management.
• Strong understanding of the US healthcare ecosystem and regulations.
• Familiarity with EMR/EHR or healthcare claims platforms is an advantage.
• Proficient in Excel and strong communication skills.

Responsibilities

• Perform healthcare operational tasks such as member, provider, claims, authorizations, or eligibility-related processes.
• Review, validate, and process healthcare information ensuring accuracy and compliance.
• Support administrative functions related to US healthcare operations and client requirements.
• Maintain and update records, databases, and documentation in healthcare systems.
• Investigate and resolve operational issues, discrepancies, or inquiries timely.
• Collaborate with cross-functional teams to improve workflow efficiency and service quality.
• Ensure adherence to HIPAA and other healthcare compliance standards.
• Monitor productivity, quality metrics, and SLAs.

Skills

Attention to detail

Analytical skills

Problem solving

Communication

Stakeholder management

Microsoft Excel

Education

Bachelor's degree preferred

Tools

EMR/EHR platforms

Healthcare claims platforms

Job description

Cloudstaff Philippines Inc. is seeking an experienced US Healthcare Operations Associate to support day-to-day health operations, ensuring accurate processing of healthcare transactions and regulatory compliance.

You will collaborate with internal teams, monitor SLAs, and uphold HIPAA standards to deliver high-quality service to US-based clients. This role emphasizes attention to detail, analytical thinking, and stakeholder management, with growth opportunities and comprehensive benefits within