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

This role will own critical customer-facing accounting operations, including the advance deposit process, IDRE refunds, applying payments to advance deposit and standard plan customer accounts, and the Finance queue of customer support tickets and refund questions. It will also provide backup coverage across revenue operations, AR, collections, and cash in and cash out. Nearly everything you touch reaches a customer, whether through our systems, through Client Success, or directly. That means we need someone who can execute with precision and reassure customers that the cash we receive is in good hands. You’ll join a busy team at an important moment, starting with working down open support tickets and closing the gaps left by an open seat.

What You'll Do

Own the advance deposit process end to end, accurately applying payments to advance deposit and standard plan customer accounts

Own IDRE refunds, processing them accurately and on time and tracking each one through to resolution

Work the Finance queue of customer support tickets and refund questions, getting to the root of each issue and resolving it quickly

Partner closely with the Client Success team, giving them clear, accurate answers so they can confidently relay information to customers

Be a friendly face in Finance: your work reaches customers through our systems, through Client Success, or directly, and you’ll help reassure them that the cash we receive is in good hands

Provide backup coverage across the team’s financial operations, including revenue operations, AR, collections, and cash in and cash out

Help a busy team close the gaps left by an open seat, starting with working down open support tickets

Quickly learn the business and the language of IDR, and adapt as our systems and processes evolve month to month

Become the go-to expert in the areas you own, then grow into a broader scope of responsibilities

What We're Looking For

Bachelor’s degree in Accounting (Finance also considered)

1–4 years of accounting experience, Big 4 experience preferred (PwC, EY, KPMG, and/or Deloitte)

Strong Excel skills

Hands-on experience with an ERP or accounting system such as Rillet, NetSuite, or QuickBooks

Comfortable with AI tools in your day to day work like Claude.

A clear communicator who can explain accounting details to teammates outside Finance and to customers; we value communication and critical thinking as much as technical experience

Comfortable managing up and keeping your manager informed

A self-starter who is results driven, smart, scrappy, and does well in ambiguity

You show up, make meaningful progress every day, and handle pressure, deadlines, and a growing to-do list with grace

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 those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description.