Act as the primary resource for Client Success teams when they encounter payor compliance issues, providing support via tickets and calls.
Manage the daily workflow of the Asana Payor Compliance queue, analyzing flagged client and payor cases and extracting claims data from Metabase to identify root causes.
Conduct in-depth investigations of payor behavior to determine why payments are being denied, including routing problems, INN processing delays, or eligibility errors.
Analyze findings and present actionable plans using clear data narratives to inform internal teams and strategy.
Serve as the initial contact for payor outreach initiatives, based on team-recommended actions.
Draft outreach emails, monitor payor inboxes, log responses, and maintain an up-to-date Payor Outreach Tracker at all stages.
Develop training and reference materials for Client Success and refine standard operating procedures as workflows change.
Identify recurring trends that can lead to systemic improvements and larger financial recoveries.

1 to 3 years of experience in healthcare operations, revenue cycle management, managed care, consulting, or an analytical role in finance or healthcare.
Demonstrated ability to use Excel effectively, including creating and managing pivot tables.
Strong interpersonal abilities: approachable, empathetic, quick to establish rapport, with a natural inclination toward customer service.
Excellent written communication skills with clarity and confidence.
Highly detail-focused and organized, capable of managing multiple tasks and tracking all threads to resolution under heavy workload conditions.

Knowledge of the No Surprises Act, the Independent Dispute Resolution (IDR) process, or the structure of health insurance TPAs and payors.
Experience with SQL, data visualization, or building dashboards in Metabase, Power BI, or similar tools.
Familiarity with workflow management platforms such as Asana or Notion.

Competitive compensation, including equity

Hybrid — Los Angeles, New York

Collaborative, low-ego team focused on making healthcare reimbursement fairer for providers

Join early as one of the first analysts on a growing team, with immediate opportunities to deliver measurable results.
Your analysis directly impacts whether clients receive payment on valid IDR claims, making your work financially significant.
Work closely with the Payor Optimization Strategist and a high-performing Client Success team at a company committed to analyst development.
Ideal for someone who enjoys working with people, thrives on data analysis, and is passionate about designing efficient processes.

Be part of a collaborative, mission-driven team working to create fairer healthcare reimbursement for providers.
While primary hiring focuses on Los Angeles and New York, exceptional candidates from other regions may be considered.
Remote and hybrid flexibility depends on role and team, with details specified in each job posting.
Ideal for individuals passionate about solving complex challenges and driving real-world impact.

Work Authorization: Candidates must be authorized to work in the United States without current or future employer sponsorship.
Equal Employment Opportunity: The company is an Equal Opportunity Employer that values diversity and is committed to an inclusive workplace. Discrimination based on race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or other protected status is not permitted.
Reasonable Accommodations: The company provides reasonable accommodations for qualified individuals with disabilities in compliance with applicable laws. Notify the company if assistance is needed during the application or interview process.
Background Checks: Employment is contingent upon passing required background checks, where allowed by law.
At-Will Employment: Employment is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Candidates must be authorized to work in the United States without current or future employer sponsorship.
Employment is contingent upon successful completion of applicable background checks, where permitted by law.
Employment is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.
Reasonable accommodations are provided for qualified individuals with disabilities in accordance with applicable laws.

Not available

Pivotal Health is hiring an Optimization Analyst