Operations Associate to the Chief Operating Officer

Reports to: Chief Operating Officer
Schedule: Full-time, 40 hrs/week, aligned to Arizona business hours (9:00 PM – 6:00 AM Philippine Standard Time). This is a permanent night-shift role.
Compensation: $[X] – $[Y] USD/month, paid semi-monthly, plus performance bonus and 13th month
Engagement: Direct hire (independent contractor), long-term

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Why this role exists

Our COO runs a multi-location interventional pain management practice: 40 employees, multiple service lines, full P&L and KPI ownership, vendor relationships, billing oversight, and a management layer of office managers who need direction and follow-through.

He does not need a travel agent. He needs a second brain — someone who learns how the clinic actually works, absorbs the recurring operational load, and then grows into owning entire workstreams. You will start by taking tasks off his plate. Within six months, you should be catching things before he asks.

If you are looking for a role where someone sends you a checklist every morning, this is not it. If you want to understand a business end-to-end and become indispensable to the person running it, keep reading.

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What you will do

Meeting and executive cadence

• Own the COO's calendar: schedule, sequence, and protect blocks of focused time
• Build agendas ahead of every recurring meeting (leadership, service line reviews, office manager check-ins, vendor calls)
• Attend meetings, capture decisions and action items, and distribute notes same-day
• Track every open action item to closure — chase the owner, escalate what is stuck, and give the COO a clean status list before each meeting
• Prepare briefing materials: pull the numbers, summarize the issue, and give him a one-page read before he walks in

Vendor and contract follow-through

• Serve as first point of contact for vendors, suppliers, and outside service providers
• Chase quotes, renewals, service tickets, and deliverables that have gone quiet
• Maintain a vendor register: contact, contract term, renewal date, spend, and current status
• Flag renewals and price increases 60 days out, with a recommendation

Finance, invoices, and AP support

• Track down missing invoices, statements, and receipts across entities and locations
• Reconcile invoices against contracts and expected pricing; escalate discrepancies
• Route items for approval and keep an aging list of what is unpaid, unbilled, or disputed
• Maintain expense documentation so nothing is scrambled for at month-end

Billing and revenue cycle liaison

• Interface with the billing team and outside billing vendors on claims, denials, and AR follow-up
• Pull and organize reports on collections, denials, aging, and payer mix
• Track open items and unanswered questions between the clinic and billing until they are resolved
• Surface patterns — a payer denying the same code repeatedly is something you should notice, not just log

Clinical and administrative records support

• Retrieve and organize charts, records, imaging reports, and documentation from EMR and payer portals
• Assemble records packets for audits, requests, personal injury matters, and internal review
• Maintain organized, correctly named, correctly filed documentation in our systems

Data, KPIs, and P&L support

• Pull recurring data and update KPI dashboards and service line scorecards on a fixed schedule
• Assist in assembling monthly P&L review materials by service line
• Build and maintain spreadsheets, trackers, and reports the COO relies on
• Do the first pass of analysis: what moved, by how much, and what looks off

Project and management support

• Track projects across the office managers and hold owners to deadlines
• Draft SOPs, checklists, memos, and internal communications
• Coordinate with the HR manager on onboarding logistics, scheduling, and documentation
• Run down whatever is blocking the COO that week — including things not on this list

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What this role is *not*

• Not travel booking and personal errands
• Not a medical scribe or patient-facing call agent
• Not a data-entry seat — you are expected to think, question, and recommend
• Not a 9-to-5 Manila schedule; our day is your night

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What we require

Experience

• 4+ years supporting executives, operations, or business management — ideally in a U.S. healthcare, medical practice, or multi-location services environment
• Demonstrated ownership of a workstream end-to-end, not just task execution
• Direct experience chasing vendors, invoices, or accounts and driving them to resolution

Skills

• Advanced Excel / Google Sheets: pivot tables, lookups, clean formatted reporting. You will be tested on this.
• Strong written English — clear, concise, professional. You will draft communications sent to U.S. vendors and staff.
• Confident spoken English on live calls with U.S. vendors, billing companies, and staff
• Comfortable with project management tools, EMR and payer portals, and learning new systems quickly
• Organized to the point that nothing needs to be asked twice

Disposition

• Proactive by default. You notice the thing that is about to go wrong and raise it.
• Comfortable holding people accountable, including people senior to you, without being abrasive
• Discreet — you will see financial, personnel, and patient information
• Willing to say "I don't know yet, I'll find out" rather than guess

Strongly preferred

• U.S. medical billing / revenue cycle exposure (denials, AR, payer portals, CPT/ICD familiarity)
• Experience in a multi-entity or multi-location business
• Prior HIPAA training

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Technical and compliance requirements

• Dedicated, private, quiet home workspace — no coworking spaces or shared rooms
• Minimum 25 Mbps wired internet with a documented backup connection
• Backup power sufficient to complete a shift through an outage
• Modern computer (16GB RAM minimum), dual monitors, noise-cancelling headset, working webcam
• Willingness to sign a Business Associate Agreement, confidentiality agreement, and complete HIPAA training before accessing any system
• Work performed only on approved devices through our secure connection; no PHI on personal devices or personal accounts

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What success looks like

By day 30 — You know our service lines, locations, entities, and key vendors. You run the meeting cadence: agendas out in advance, notes out same-day, action items tracked. The COO stops reminding you about recurring items.

By day 90 — You independently own vendor follow-up, invoice tracking, and records retrieval. KPI reports are updated without prompting. You are the first call for the billing team, and you close loops without escalating every question.

By day 180 — You anticipate. You bring the COO problems with a proposed answer attached. He can be out for a week and the operational machinery keeps running.

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How to apply

Applications without all three items below will not be reviewed.

1. Your resume, plus one paragraph on the most complex operational problem you have personally untangled — what was broken, what you did, what changed.
2. A 3-minute video (unedited, speaking to camera): introduce yourself, describe your current work setup and internet, and explain how you would handle this situation — *a vendor has not delivered a service invoice for two months, your accounting contact says it was never received, and the vendor insists it was sent. Your executive asks about it in tomorrow's meeting. Walk us through exactly what you do.*
3. Confirmation that you can reliably work 9:00 PM – 6:00 AM Philippine time, long-term.

Shortlisted candidates will complete a paid practical assessment (approximately 2 hours) covering spreadsheet work, written communication, and a live problem-solving conversation.