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 an Accounts Payable Analyst to support Pivotal’s Payor Compliance team, focused on payment processing and refunds. Refunds are a core, ongoing part of the role: you’ll own the weekly fee-refund cycle and serve as the point person for refund questions, alongside supporting payment processing through the manual intervention queue and maintaining Payor Compliance process documentation.

This role sits at the intersection of data, process, and client impact. You’ll work directly in Metabase and BigQuery to reconcile payments and refunds, identify structural blockers to payment, and serve as the primary point of contact for refund questions coming in from Client Success.

This is a great opportunity for someone with professional experience who enjoys detail-oriented operational work and wants to develop expertise in payor behavior, healthcare reimbursement, and the No Surprises Act IDR process.

What You’ll Do

• Run the weekly refund cycle: Process the weekly fee-refund upload (won or ineligible IDR cases), matching remit amounts precisely against bricks received and escalating any discrepancies to Finance — a high-volume, detail-heavy cycle (roughly $2.5M processed weekly).

• Field refund inquiries: Be the go-to for Client Success “where’s my refund” questions, using the refunds Metabase dashboard and dispute status tool to track down and resolve missing or delayed refunds.

• Independently build and maintain relationships with Independent Dispute Resolution Entities (IDREs) to help expedite the collection of outstanding refunds owed to the practice.

• Proactively drive communications between Client Success, IDREs, Business Operations, and Accounting to ensure alignment

• Establishing and driving new processes: to meet the evolving needs of the business and our customers.

• Maintain process and documentation: Maintain and improve Payor Compliance SOPs as workflows evolve, and flag patterns across payment and refund exceptions that point to systemic issues worth escalating to the team.

• Flag payment platform issues: Identify cases where the platform incorrectly marks a lost dispute as a win, and escalate to engineering with supporting evidence.

Who You Are

• 2–3 years of experience in healthcare operations, revenue cycle, managed care, or a related field

• Comfort working directly in data — pulling and interpreting reports in tools like Metabase, BigQuery, or similar; basic SQL is a plus

• Strong written communication — you’ll regularly write clear explanations of payment and refund issues that Client Success depends on to answer client questions

• Detail-oriented and thorough — this role requires following a thread all the way through, going beyond flagging issues

• Organized under volume — able to manage a high-volume weekly refund cycle and multiple open payment exceptions simultaneously without dropping the ball

• Comfortable working in Excel, Google Sheets, Metabase, or BigQuery to track cases and analyze claims data

• Collaborative — you’ll work closely with the Payor Compliance and Client Success teams and need to communicate proactively when things are blocked or unclear

• Analytical thinker who can evaluate claim and payor data to identify root causes and determine appropriate next steps

• Strong data entry accuracy and comfort with detail-heavy, matching-based reconciliation work, where amounts need to line up exactly

Extra Credit if you have:

• Familiarity with the No Surprises Act (NSA), the federal IDR process, or health insurance payor/TPA structures

• Comfortable working with payment and remittance data (e.g., 835 remits) to reconcile refunds and resolve payment posting exceptions

• Experience with Asana, Notion, Metabase, or similar workflow and reporting tools

• Background in revenue cycle payment posting, refund reconciliation, or 835 remittance processing

• Accounting, bookkeeping, or accounts receivable/payable background

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.