Payor Dispute Coordinator at Pivotal Health

, , United States -

Full Time

Start Date

Immediate

Expiry Date

20 Jun, 26

Salary

75000.0

Posted On

22 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Dispute Resolution, Case Management, Documentation Review, Analytical Thinking, Regulatory Guidelines, Attention To Detail, Excel, Google Sheets, Case Tracking, Workflow Refinement, Written Communication

Industry

Wellness and Fitness Services

Description

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 a Payor Dispute Coordinator 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 early professional experience who enjoys detail-oriented operational work and wants to develop expertise in healthcare reimbursement and regulatory processes. What You’ll Do Manage federal IDR case workflows: Review and prepare dispute submissions, documentation, and case tracking across the federal arbitration process. 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. Resolve submission issues and resubmissions: Identify errors or missing documentation and coordinate corrections to ensure disputes remain compliant and on schedule. Support operational improvements: Contribute to refining workflows and documentation as the team builds more scalable dispute management processes. Who You Are 2–4 years of experience in healthcare, insurance, reimbursement operations, or a similar regulated operational environment 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 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.

Responsibilities

The coordinator will manage federal Independent Dispute Resolution (IDR) case workflows, including reviewing submissions, tracking arbitration timelines, and ensuring all documentation meets federal requirements. This involves analyzing claim information, monitoring correspondence from various entities, and maintaining accurate operational records.