Similar Jobs
See allSenior Healthcare Economics Analyst
RightMove
US
SQL
Python
Excel
Payment Integrity Analyst
Clover Health
US
Medicare Advantage
SQL
Excel
Lead Claims Analyst
OneImaging
US
Revenue Cycle Management
Denials Management
Data Analysis
Operations Analyst
Aptive
US
Microsoft Excel
Microsoft PowerPoint
Microsoft Word
Sr. Product Consultant
NASCO
US
Consulting
Data Analysis
Executive Communication
About the Role:
- You'll be the team's first Optimization Analyst, owning intake for payor eligibility inquiries and standing up the ineligible claims review process.
- You'll help move eligibility catches from reactive to proactive, reducing wasted filings for clients.
What You'll Do:
- Be the go-to for Client Success on eligibility tickets and calls, pulling claims data to get to root cause.
- Run the ineligible claims review, separating truly ineligible claims from product defaults and driving corrective actions with Product.
- Build eligibility-risk dashboards and shape the playbook for how disputed flags are handled.
Who You Are:
- You have 1-3 years in healthcare operations, revenue cycle, consulting, or finance, with strong Excel and basic SQL skills.
- You're warm, detail-oriented, and collaborative, with clear writing that CS can take directly to clients.
Pivotal Health
Pivotal Health is a technology platform that helps healthcare providers get paid fairly in a complex reimbursement landscape by simplifying IDR workflows with AI-driven software, data, and service. The team is collaborative and low-ego, building solutions for reimbursement clarity, with a mission to make healthcare reimbursement fairer for providers.