Job Overview
Location
Remote - US
Job Type
Full-time
Category
HR & Recruiting
Date Posted
March 23, 2026
Full Job Description
đź“‹ Description
- • The Payor Dispute Coordinator plays a critical role in ensuring healthcare providers receive fair reimbursement by managing federal Independent Dispute Resolution (IDR) case workflows, directly supporting Pivotal Health’s mission to simplify complex reimbursement processes and reduce administrative burden on care teams.
- • This role is essential to maintaining compliance, accuracy, and timeliness in dispute submissions, enabling providers to recover rightful payments without increasing operational strain.
- • Day-to-day responsibilities include reviewing and preparing dispute submissions and supporting documentation for federal IDR processes, ensuring all materials meet regulatory requirements before filing.
- • Evaluating claim data to assess eligibility for IDR, identifying gaps or inconsistencies in documentation, and determining appropriate next steps to strengthen case validity.
- • Monitoring arbitration timelines, tracking correspondence from health plans and arbitration entities, and proactively managing deadlines to prevent delays or dismissals.
- • Maintaining accurate operational records in internal systems and spreadsheets, including case statuses, submission dates, and key metrics to support reporting and process improvements.
- • Identifying submission errors or missing information and coordinating corrections with internal teams or external partners to keep cases compliant and on track.
- • Contributing to the refinement of workflows and documentation as the team scales its dispute management capabilities, helping build more efficient and scalable processes.
- • Working within a mission-driven, collaborative team focused on transforming healthcare reimbursement through technology, data, and service innovation.
- • Opportunity to develop deep expertise in federal healthcare regulatory processes, IDR mechanics, and reimbursement operations while building transferable skills in data tracking, analytical reasoning, and cross-functional coordination.
🎯 Requirements
- • 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 capable of evaluating case information to determine eligibility and appropriate next steps in federal IDR processes
- • Comfortable working in Excel or Google Sheets to track cases, deadlines, and operational metrics
- • Ability to manage multiple cases, deadlines, and regulatory timelines simultaneously in a fast-paced environment
- • Strong written communication skills for coordinating with internal teams and external partners such as health plans and arbitration entities
🏖️ Benefits
- • Competitive compensation package including equity participation
- • Full health, dental, and vision coverage for employees
- • Retirement savings plan through 401(k) with company support
- • Flexible time off policy to support work-life balance
- • Opportunities for company-wide connection, events, and team building
Skills & Technologies
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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