Accounts Payable Analyst

Pivotal Health•New York, NY

About The Position

Pivotal Health is seeking an Accounts Payable Analyst to join their Payor Compliance team. This role will focus on payment processing and refunds, with a significant emphasis on managing the weekly fee-refund cycle and serving as the primary point of contact for refund-related inquiries. The analyst will also support payment processing through the manual intervention queue and maintain Payor Compliance process documentation. This position offers the opportunity to work with data in Metabase and BigQuery to reconcile payments and refunds, identify systemic issues in payment processes, and gain expertise in payor behavior, healthcare reimbursement, and the No Surprises Act IDR process.

Requirements

2–3 years of experience in healthcare operations, revenue cycle, managed care, or a related field.
Comfort working directly in data, pulling and interpreting reports in tools like Metabase, BigQuery, or similar.
Basic SQL is a plus.
Strong written communication skills for explaining payment and refund issues.
Detail-oriented and thorough approach to problem-solving.
Ability to manage a high-volume weekly refund cycle and multiple open payment exceptions simultaneously.
Comfortable working in Excel, Google Sheets, Metabase, or BigQuery for tracking and analysis.
Collaborative attitude and proactive communication skills.
Analytical thinker capable of evaluating claim and payor data to identify root causes.
Strong data entry accuracy and comfort with detail-heavy reconciliation work.

Nice To Haves

Familiarity with the No Surprises Act (NSA), the federal IDR process, or health insurance payor/TPA structures.
Comfortable working with payment and remittance data (e.g., 835 remits) for reconciliation.
Experience with Asana, Notion, Metabase, or similar workflow and reporting tools.
Background in revenue cycle payment posting, refund reconciliation, or 835 remittance processing.
Accounting, bookkeeping, or accounts receivable/payable background.

Responsibilities

Process the weekly fee-refund upload, matching remit amounts precisely against received payments and escalating discrepancies.
Respond to refund inquiries from Client Success, using dashboards and tools to track and resolve issues.
Build and maintain relationships with Independent Dispute Resolution Entities (IDREs) to expedite refund collection.
Drive communication between Client Success, IDREs, Business Operations, and Accounting to ensure alignment.
Establish and drive new processes to meet evolving business and customer needs.
Maintain and improve Payor Compliance Standard Operating Procedures (SOPs).
Flag patterns in payment and refund exceptions that indicate systemic issues.
Identify and escalate cases where the platform incorrectly marks a lost dispute as a win to engineering with supporting evidence.