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
We're looking for an Optimization Analyst to help with our fast growing team! This Optimization Analyst sits within Operations on our Upstream Eligibility team, which makes sure the claims entering IDR are eligible so providers actually collect on their determinations. You'll be the team's first Optimization Analyst and the first point of intake for payor eligibility inquiries. Found on 1752vc Careers, the job board for startup and VC roles.
What they're looking for
- People energize you. You're warm, personable, and quick to build trust, with customer-service instincts in every conversation with CS and payors
- You write with clarity and confidence. Your findings and rationale become the language CS takes straight to clients
- You're the reliable one: detail-oriented and organized under volume, following every thread to the finish. You like the build-up as much as the big win, and you're curious, low-ego, and easy to give feedback to
- You're a partner, not a lone wolf. The corrective-action loop with Product and the relationship with CS only work for someone who likes working across teams
- Familiarity with the No Surprises Act, IDR eligibility rules, or health plan structures (self-funded vs. fully insured, state vs. federal jurisdiction)
- Advanced SQL, data storytelling, or dashboard know-how in Metabase, Power BI, or similar
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.
We're looking for an Optimization Analyst to help with our fast growing team!
This Optimization Analyst sits within Operations on our Upstream Eligibility team, which makes sure the claims entering...
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