Pivotal Health delivers full-service Independent Dispute Resolution (IDR) technology to help providers recover fair reimbursement with less administrative burden. Backed by Bessemer.
About the role
Evaluate dispute eligibility and documentation: Analyze claim information to ensure cases meet federal IDR or state-specific dispute requirements before submission . Research and interpret state regulatory requirements: For state-specific work, independently research state laws, regulations, agency guidance, payer requirements, and arbitration procedures; interpret how they apply operationally; and translate that research into clear, reliable instructions and workflows for the rest of the team.
What they're looking for
- 2–4 years of experience in revenue cycle operations, claims management, or reimbursement/insurance operations
- Experience with medical billing or coding, comfortable reading EOBs, claims, and reimbursement codes
- Comfortable working in Excel or Google Sheets, including building and using pivot tables, to track cases and data
- Strong attention to detail and analytical thinking, ability to review documentation, catch inconsistencies, and determine next steps
- Ability to manage a high volume of competing deadlines with strong written communication
- Comfortable exercising judgment and asking thoughtful questions rather than waiting for every next step to be prescribed, able to make well-supported recommendations and grow into more independent ownership of your day to day
More about this role
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 an IDR Analyst to support Pivotal’s healthcare dispute resolution workflows, including Independent Dispute Resolution (IDR) processes. In this role, you’ll manage...
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