Dispute Resolution Coordinator

Pivotal Health Inc.

Job Overview

Location

Remote - US

Job Type

Full-time

Full Job Description

📋 Description

• The Dispute Resolution Coordinator plays a critical role in ensuring healthcare providers receive fair reimbursement by managing Independent Dispute Resolution (IDR) workflows across multiple state arbitration systems, directly supporting Pivotal Health’s mission to reduce administrative burden and recover rightful payments for providers.
• This role is essential to maintaining the integrity and efficiency of the dispute resolution process, where timely and accurate case management prevents revenue loss and enables providers to focus on patient care rather than bureaucratic hurdles.
• Support state IDR workflows: Manage dispute submissions, documentation, and case tracking across assigned states while ensuring all deadlines, jurisdictional requirements, and procedural rules are met with precision.
• Monitor arbitration timelines and correspondence: Review inbound communications from health plans, arbitration entities, and internal teams to verify case progression, identify bottlenecks, and escalate issues when necessary to maintain momentum.
• Maintain operational tracking and documentation: Update internal systems, spreadsheets, and databases to keep accurate, auditable records of case statuses, submission dates, outcomes, and key metrics for reporting and process improvement.
• Assist with dispute corrections and resubmissions: Proactively identify errors, missing documentation, or non-compliant submissions and coordinate timely resubmissions with internal and external stakeholders to avoid delays or dismissals.
• Support operational cleanup work: Aid in refund processing, case reconciliation, and duplicate case resolution to ensure data integrity and financial accuracy across the dispute portfolio.
• Help establish repeatable workflows: Contribute to the documentation, refinement, and standardization of internal processes as state regulations evolve, enabling scalability and consistency as the IDR program grows.
• About the team or company: Pivotal Health is a mission-driven technology company transforming healthcare reimbursement by combining AI-powered software, data analytics, and expert services to empower providers in navigating complex insurance reimbursement landscapes.
• The team operates with a low-ego, collaborative culture focused on solving real-world problems in healthcare finance, valuing initiative, curiosity, and a commitment to fairness in provider reimbursement.
• What the person can learn or achieve in this role: Gain deep exposure to healthcare reimbursement systems, state-specific arbitration regulations, and revenue cycle operations, building a strong foundation for a career in healthcare operations, compliance, or health tech.
• Develop expertise in process optimization, regulatory compliance, and cross-functional coordination while contributing to meaningful improvements that directly impact provider revenue and reduce administrative waste.

🎯 Requirements

• 1–3 years of professional experience in an operational, administrative, or healthcare-related environment
• Organized and highly detail-oriented, with the ability to follow structured processes and manage multiple concurrent workflows
• Comfortable working in Excel or Google Sheets to track operational workflows, maintain records, and generate basic reports
• Strong written communication skills for coordinating with internal teams and external partners such as health plans and arbitration entities
• Able to manage multiple tasks, deadlines, and case workflows simultaneously while maintaining accuracy and consistency
• Dependable and consistent in executing repeatable operational processes, with a quick learning mindset and openness to feedback

🏖️ Benefits

• Competitive compensation, including equity participation in the company’s growth
• Full health, dental, and vision coverage for employees and dependents
• Retirement savings plan through a 401(k) with potential company matching
• Flexible time off policy supporting work-life balance and personal well-being
• Opportunities for company-wide connection and events to foster team cohesion and engagement

Skills & Technologies

Remote

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Pivotal Health Inc.

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About Pivotal Health Inc.

Pivotal Health is a health technology company focused on improving the healthcare experience for patients and providers. They offer a platform designed to streamline administrative tasks, enhance patient engagement, and provide data-driven insights for healthcare organizations. Their solutions aim to reduce costs, improve efficiency, and ultimately lead to better health outcomes. Pivotal Health operates within the digital health and health IT sectors, leveraging technology to address challenges in healthcare delivery and management. The company is committed to innovation and creating a more connected and accessible healthcare ecosystem.

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