Payor Dispute Coordinator

Payor Dispute Coordinator 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 ... (truncated, view full listing at source)