[Hiring] Payor Dispute Analyst @Pivotal Health

Role Description

We’re looking for an Analyst to support Pivotal’s federal healthcare dispute resolution workflows, including Independent Dispute Resolution (IDR) processes. In this role, you’ll manage dispute cases through the federal arbitration process, ensuring claims are reviewed, submitted, and tracked accurately. Federal IDR processes require strong attention to detail and analytical thinking to evaluate eligibility, documentation, and case requirements. You’ll work closely with internal teams and external partners to ensure disputes meet regulatory guidelines and progress through the arbitration process successfully. This is a great opportunity for someone with professional experience who enjoys detail-oriented operational work and wants to develop expertise in healthcare reimbursement and regulatory processes.

What You’ll Do

• Evaluate dispute eligibility and documentation: Analyze claim information to ensure cases meet federal IDR requirements before submission.
• Monitor arbitration timelines and correspondence: Track deadlines and review communications from health plans, arbitration entities, and internal teams to ensure cases progress appropriately.
• Maintain operational tracking and documentation: Update internal systems and spreadsheets to maintain accurate case records, dispute statuses, and operational metrics.
• Support operational improvements: Contribute to refining workflows and documentation as the team builds more scalable dispute management processes.

Qualifications

• 2–4 years of experience in revenue cycle operations, with focus on claims management, appeals, insurance, and reimbursement.
• Actively participate in team-based problem solving, knowledge sharing, and continuous improvement efforts.
• Engage in cross-training initiatives to build proficiency in multiple roles and functions within the team.
• Strong attention to detail with the ability to review documentation and identify inconsistencies or errors.
• Analytical thinker who can evaluate case information and determine eligibility or appropriate next steps.
• Comfortable working in Excel or Google Sheets to track cases and operational data.
• Able to manage multiple cases, deadlines, and regulatory timelines simultaneously.
• Strong written communication skills when coordinating with internal teams and external partners.

Extra Credit Experience

• Familiarity with Independent Dispute Resolution (IDR), arbitration, or healthcare regulatory workflows.
• Experience working with operational tools such as Asana, Metabase, or similar systems.

Benefits

• 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.

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.