Pivotal Health
Pivotal Health
„Pivotal Health“ yra sveikatos priežiūros technologijų įmonė, padedanti ligoninėms ir specializuotoms praktikoms siekti teisingo atlygio, naudodama integruotą nepriklausomo ginčų sprendimo (IDR) platformą. Jos SaaS sprendimas sujungia darbo eigos automatizavimą, duomenis ir valdomas paslaugas, kad padėtų tikrinti tinkamumą, teikti paraiškas ir apskųsti sprendimus, taip pat prisijungti prie pagrindinių pajamų ciklo valdymo sistemų. „Pivotal Health“ taip pat teikia praktinę pagalbą viso proceso metu ir taiko su rezultatais susietą modelį, pagal kurį klientai moka tik pasiekus sėkmingų rezultatų. Įmonės veikla orientuota į sveikatos priežiūros paslaugų teikėjų pajamų susigrąžinimo, skaidrumo ir veiklos efektyvumo gerinimą.

Accounts Payable Analyst – Healthcare Payments

Manage refunds, payment reconciliation, and payor compliance for Pivotal Health’s healthcare reimbursement platform. Support independent dispute resolution workflows and resolve payment issues with clients and internal teams.

Aprašymas

  • Process weekly fee-refund uploads for won or ineligible IDR cases, compare remit amounts with received bricks, and escalate discrepancies to Finance
  • Act as the primary contact for Client Success refund questions, using Metabase and the dispute status tool to track missing or delayed payments
  • Develop and maintain relationships with Independent Dispute Resolution Entities to accelerate outstanding refunds owed to practices
  • Coordinate communications among Client Success, IDREs, Business Operations, and Accounting
  • Create and implement processes that address changing business and customer needs
  • Maintain and enhance Payor Compliance SOPs as workflows develop
  • Analyze payment and refund exceptions for recurring patterns that may signal systemic issues, then escalate findings
  • Investigate platform errors in which lost disputes are recorded as wins and provide supporting evidence to Engineering
  • Reconcile payments and refunds, identify structural payment blockers, and assist processing through the manual intervention queue

Reikalavimai

  • 2–3 years of experience in healthcare operations, revenue cycle, managed care, or a related field
  • Comfort working directly with data in Metabase, BigQuery, or similar tools; basic SQL is a plus
  • Strong written communication skills
  • A detail-oriented and thorough approach to work
  • Ability to manage a high-volume weekly refund cycle alongside multiple open payment exceptions
  • Proficiency with Excel, Google Sheets, Metabase, or BigQuery
  • Analytical skills for evaluating claim and payor data, identifying root causes, and determining next steps
  • Highly accurate data entry and careful matching-based reconciliation skills
  • Familiarity with the No Surprises Act, the federal IDR process, or health insurance payor and TPA structures is a plus
  • Experience handling payment and remittance data, including 835 remits, is a plus
  • Experience with Asana, Notion, Metabase, or similar workflow and reporting tools is a plus
  • Background in revenue cycle payment posting, refund reconciliation, 835 remittance processing, accounting, bookkeeping, or accounts payable and receivable is a plus
  • Authorization to work in the United States without current or future employer sponsorship

Privalumai

  • Competitive compensation with equity
  • Full health, dental, and vision coverage
  • 401(k) retirement savings plan
  • Flexible time off
  • Company-wide connection opportunities and events
  • Remote and hybrid flexibility varies by role and team

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