Analyst, State Dispute Operations

Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape.

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 a State Dispute Analyst to handle the day-to-day filing and tracking of Pivotal’s state-level healthcare reimbursement disputes. You’ll prepare and submit disputes through state portals, agencies and arbitration entities. You’ll track deadlines and fees while ensuring accurate case records from filing through resolution.

Each state runs its process differently, with its own deadlines, forms, fees and submission rules. You’ll work from the team’s state-by-state references, follow them closely and flag anything that looks off or has changed. You’ll sit within our dispute operations team while working with our analytics and product teams to keep case data clean.

This is a great fit for someone who is highly detail-oriented, likes fast changing, high-volume work and wants to build expertise in healthcare reimbursement. In this work, one missing detail can delay a provider’s payment.

• 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.

• 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

• Familiarity with the federal No Surprises Act and how it interacts with state surprise…