Analyst, State Dispute Operations

The role

The State Dispute Analyst handles the day-to-day filing and tracking of state-level healthcare reimbursement disputes. This person prepares and submits disputes through state portals, agencies, and arbitration entities while tracking deadlines and fees.

What you will do

• Enter and submit state dispute and arbitration requests through state portals, agencies and arbitration entities.
• Monitor filing and response deadlines, process fees and confirm payers pay awarded amounts.
• Follow up when a payment is late or incorrect.
• Monitor shared inboxes, respond to payers, state agencies and arbitration entities, and log next steps for each case.
• Update internal systems and spreadsheets with case details and statuses.
• Work from state references for eligibility, deadlines, forms and fees, and flag rule changes or gaps.
• Tell analytics and product teams when a case file is incomplete or inaccurate.

Required qualifications

• 2–4 years of experience in data management, operational tracking, revenue cycle operations, claims management, or insurance operations
• Experience with medical billing or coding, and comfortable reading EOBs, claims and reimbursement codes
• Comfortable in Excel or Google Sheets, including pivot tables
• Highly detail-oriented, and catches inconsistencies in documents and data
• Manages high volume and competing deadlines accurately
• Comfortable following detailed, state-specific processes
• Clear written communicator who asks good questions and flags problems early

Nice to have

• Familiarity with the federal No Surprises Act and how it interacts with state surprise billing laws
• Prior experience with state arbitration programs (e.g., New York, New Jersey, Texas)
• Experience with tools like Asana or Metabase or other project management tools
• Medical billing/coding certification (e.g., CPC)

Benefits

• Competitive compensation, including equity
• Full health, dental, and vision coverage
• Retirement savings plan through 401(k)
• Flexible time off
• Opportunities for company-wide connection and events

Before you apply

• 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.

About the company

Pivotal Health is a technology platform that helps healthcare providers get paid fairly through an AI-driven platform that simplifies reimbursement workflows.