US Healthcare Operations Associate | WFO

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

Job Description

Position Overview

The US Healthcare Operations Associate is responsible for supporting day-to-day healthcare operations, ensuring accurate processing of healthcare-related transactions, maintaining compliance with client and regulatory requirements, and coordinating with internal and external stakeholders to support efficient healthcare service delivery.

Key Responsibilities

• Perform healthcare operational tasks such as member, provider, claims, authorizations, or eligibility-related processes.
• Review, validate, and process healthcare information while ensuring accuracy and compliance with established guidelines.
• 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 in a timely manner.
• 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 service-level agreements (SLAs).

Qualifications and Requirements

Qualifications

• Bachelor's degree preferred.
• 2–5 years of experience in US healthcare operations.
• Experience working with one or more areas such as:
  • Claims processing
  • Prior authorization
  • Eligibility and benefits verification
  • Provider data management
  • Revenue cycle management
  • Healthcare customer support
  • Medical billing or healthcare administration
• Strong understanding of the US healthcare ecosystem, including payers, providers, and healthcare regulations.
• Familiarity with healthcare systems, EMR/EHR platforms, or healthcare claims platforms is an advantage.
• Proficient in Microsoft Excel and other productivity tools.
• Strong attention to detail, analytical, and problem-solving skills.
• Excellent communication and stakeholder management skills.

Preferred Background

• Experience supporting US-based healthcare clients.
• Knowledge of HIPAA compliance and healthcare data privacy standards.
• Experience in process improvement, quality assurance, or healthcare operations support functions.

Perks and Benefits

• HMO Coverage
• Annual Performance Review with Salary Increase
• Become part of the Employee Share Units program
• Cloudstaff Dream Points - To be used for bidding useful items like appliances, kitchenettes etc.
• Comprehensive health and life insurance on your 16th day of employment, covering 1 free dependent on the 16th day of employment
• Endless opportunities for career advancement
• Flexible leave credits which may be used for vacation, emergency, and sick leaves
• In-house psychiatrist available to support employees' well-being
• International career growth and connections
• Look forward to weekly office perks for work from office staff – Free Coffee, Meals, and Beer Fridays!
• Mental Wellness Employee Assistance program through Lifeworks
• Participate and join our CS Social Clubs and Special Interest Groups to connect with colleagues
• Superb and exciting Mid-Year Parties – with items to give away and cash prizes!
• Top notch workplace with first class VIP lounge and game rooms
• Unlimited cash incentives for hired referrals
• We set you up for success with a company-provided PC/Laptop and fiber internet connection