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ABOUT PIVOTAL HEALTH
Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape.
Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools.
Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams.
Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey.
About the Role
We’re looking for a State Dispute Analyst to handle the day-to-day filing and tracking of Pivotal’s state-level healthcare reimbursement disputes. You’ll prepare and submit disputes through state portals, agencies and arbitration entities. You’ll track deadlines and fees while ensuring accurate case records from filing through resolution.
Each state runs its process differently, with its own deadlines, forms, fees and submission rules. You’ll work from the team’s state-by-state references, follow them closely and flag anything that looks off or has changed. You’ll sit within our dispute operations team while working with our analytics and product teams to keep case data clean.
This is a great fit for someone who is highly detail-oriented, likes fast changing, high-volume work and wants to build expertise in healthcare reimbursement. In this work, one missing detail can delay a provider’s payment.
What You’ll Do
- Prepare and submit filings: Enter and submit state dispute and arbitration requests through state portals, agencies and arbitration entities, following each state’s documentation and formatting requirements.
- Track deadlines, fees and payments: Monitor filing and response deadlines, process fees and confirm payers pay awarded amounts. Follow up when a payment is late or incorrect.
- Manage inbox and correspondence: Monitor shared inboxes, respond to payers, state agencies and arbitration entities, and log next steps for each case.
- Keep case records accurate: Update internal systems and spreadsheets with case details and statuses, and close disputes only once they’re fully resolved.
- Follow state requirements: Work from state references for eligibility, deadlines, forms and fees, and flag rule changes or gaps so the references stay current.
- Flag data issues: Tell our analytics and product teams when a case file is incomplete or inaccurate.
Who You Are
- 2–4 years of experience in data management, operational tracking, revenue cycle operations, claims management, or insurance operations
- Experience with medical billing or coding, and comfortable reading EOBs, claims and reimbursement codes
- Comfortable in Excel or Google Sheets, including pivot tables
- Highly detail-oriented, and catches inconsistencies in documents and data
- Manages high volume and competing deadlines accurately
- Comfortable following detailed, state-specific processes
- Clear written communicator who asks good questions and flags problems early
Extra Credit Experience
- Familiarity with the federal No Surprises Act and how it interacts with state surprise billing laws
- Prior experience with state arbitration programs (e.g., New York, New Jersey, Texas)
- Experience with tools like Asana or Metabase or other project management tools
- Medical billing/coding certification (e.g., CPC)
WHY YOU’LL LOVE WORKING HERE
We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description.
If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you.
Benefits Include:
- Competitive compensation, including equity
- Full health, dental, and vision coverage
- Retirement savings plan through 401(k)
- Flexible time off
- Opportunities for company-wide connection and events
Ready to Make an Impact? We’re building something meaningful; and we want you on the team.
Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together.
EMPLOYMENT INFORMATION
Work Authorization
Candidates must be authorized to work in the United States without current or future employer sponsorship.
Equal Employment Opportunity
Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.
Reasonable Accommodations
Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know.
Background Checks
Employment is contingent upon successful completion of applicable background checks, where permitted by law.
At-Will Employment
Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.
