Note: The job is a remote job and is open to candidates in USA. Pivotal Health is hiring an analyst to manage the filing and tracking of state-level healthcare reimbursement disputes. The role prepares and submits dispute filings, tracks deadlines and payments, maintains accurate case records, and flags process or data issues to partner teams.
Responsibilities
- 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
Skills
- 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
- Candidates must be authorized to work in the United States without current or future employer sponsorship
- 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)
Benefits
- Equity
- Full health, dental, and vision coverage
- Retirement savings plan through 401(k)
- Flexible time off
- Opportunities for company-wide connection and events
- Remote work in the United States
Company Overview