Healthcare Payor Compliance & Refunds Analyst

Pivotal Health; United States; Remote; USD 52,000 - 76,000; Full time

Job summary

Pivotal Health is a technology platform helping healthcare providers navigate complex reimbursement. The Refunds Support role focuses on accurate payment processing and timely refunds within the Payor Compliance team.

The ideal candidate has 2–3 years in healthcare operations and is comfortable with tools like Metabase, BigQuery, and Excel, bringing meticulous attention to detail to high-volume workflows. You will collaborate with Client Success, Finance, and Operations to continuously improve

Qualifications

• 2–3 years in healthcare operations, revenue cycle, or managed care.
• Proficiency with Metabase, BigQuery, Excel, or similar tools.
• Detail-oriented and organized under high-volume workflows.

Responsibilities

• Process weekly fee-refund uploads and reconcile remit amounts.
• Drive communications between Client Success, IDREs, and Accounting.
• Maintain and improve Payor Compliance SOPs.

Skills

Detail-oriented

Organized

Healthcare operations knowledge

Education

2-3 years in healthcare operations, revenue cycle, or managed care

Tools

Metabase

BigQuery

Excel

Job description

Pivotal Health is a technology platform helping healthcare providers navigate complex reimbursement. The Refunds Support role focuses on accurate payment processing and timely refunds within the Payor Compliance team.

The ideal candidate has 2–3 years in healthcare operations and is comfortable with tools like Metabase, BigQuery, and Excel, bringing meticulous attention to detail to high-volume workflows. You will collaborate with Client Success, Finance, and Operations to continuously improve