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Pivotal Health
Brooklyn, New York, United States; New York City, New York, United States
Source: Pivotal Health careers · View original posting
From Pivotal Health's posting. “We” and “our” refer to the employer.
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.
Pivotal Health is looking for an IDRE Manager to own and professionalize the relationships that sit at the center of our arbitration and reimbursement operations. Independent Dispute Resolution Entities (IDREs) are CMS-approved intermediaries in the No Surprises Act arbitration process, and Pivotal Health currently manages 16+ of these relationships across both federal and state-level arbitration.
Today, engagement with IDREs is fragmented; this role will build the structure, cadence, and escalation process needed to manage those relationships proactively rather than reactively.
This is a highly relational, highly organized role. You'll be the person who knows exactly where every dispute sits in the aging cycle, which IDREs are falling out of compliance, and how to get movement, while also translating what you're seeing on the ground into clear, digestible input for Ops, Product, and Engineering so the business can close gaps and improve its processes over time.
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