AR/AP Clerk

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 this Role

Pivotal Health is hiring an AR/AP Clerk to join our Accounting team at a real inflection point in our growth. As we've scaled, so has the complexity of our billing, collections, and payables workflows - and we need someone who can own these processes end-to-end without a lot of hand-holding. This role exists because the work is real, the volume is growing, and we need someone who takes genuine pride in keeping the books clean.

You'll own the full AR cycle, sending invoices, following up on outstanding balances, processing cash receipts, and making deposits, alongside AP responsibilities including reviewing and approving expense reports and reimbursements through Ramp. You'll set up and maintain a consistent customer outreach cadence, track aging, and report on collection status weekly and monthly. Where most people wait to be told something is wrong, you find it first.

If you get satisfaction from a clean AR aging report, aren't afraid to call a customer to resolve a balance discrepancy, and want real visibility into how a growing company operates financially, this is a strong fit. You'll work directly with the Controller and have ownership of processes that matter from day one.

What You'll Do

• Own the full billing cycle. Drive weekly and monthly invoicing from generation through delivery - accurate, on schedule, and fully tracked every time.
• Build and hold a collections cadence. Send statements, follow up on outstanding balances, and maintain a consistent outreach rhythm that keeps receivables moving without burning customer relationships.
• Process and apply cash receipts. Handle incoming payments accurately, apply cash correctly, and make deposits - maintaining a clean record at every step.
• Manage accounts payable and expense reimbursements. Review, approve, and process expense reports through Ramp, ensuring policy compliance and proper GL coding.
• Report on AR aging. Produce weekly and monthly aging summaries, flag risk proactively, and keep the Controller informed on anything that needs attention.
• Enforce your own internal controls. Double-check amounts, verify payment terms, confirm vendor changes, and review before submitting so others don't have to clean up downstream.
• Communicate directly with customers. Reach out professionally on account status, open items, and payment timelines including picking up the phone when email isn't moving things forward.

What We're Looking For

• 3-5 years of hands-on AR/AP experience, with stronger depth on the AR side. You've owned billing cycles, managed collections, and processed cash before.
• Advanced Excel skills: VLOOKUPs, pivot tables, and building your own trackers from scratch without being asked.
• Comfortable in expense management tools like Ramp, Bill.com, Expensify, or Brex. You know how to work in these systems, not just around them.
• Familiar with a core financial system, NetSuite, QuickBooks, or Rillet, and disciplined about what you enter into it.
• Accountable and self-directed: you don't wait to be told something is off. You find it, fix it, and report back.
• Low-ego and coachable: you respond well to feedback, ask good questions, and care more about getting it right than being right.
• Comfortable saying no when needed, tactfully, with a reason, and with an alternative where possible.

Extra Credit Experience

• You've lived through a system migration: moving financial data from one platform to another and know what that process demands.
• Prior experience on a finance team that was building processes, not just inheriting them.
• Familiarity with healthcare or SaaS billing models.

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.

If you're excited by solving complex problems and making a real-world impact, we'd love to hear from you.

Benefits Include:

• 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

Ready to Make an Impact? We're building something meaningful; and we want you on the team.

Bring your ideas, curiosity, and drive, and let's transform healthcare reimbursement together.

Employment Information

Work Authorization

Candidates must be authorized to work in the United States without current or future employer sponsorship.

Equal Employment Opportunity

Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.

Reasonable Accommodations

Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know.

Background Checks

Employment is contingent upon successful completion of applicable background checks, where permitted by law.

At-Will Employment

Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.