Title: AR/AP Clerk

Location: Remote

Reporting Structure: Boyd Evans

Company Description

Healthcare reimbursement is broken - too complex, too opaque, and too often unfair to the providers delivering care and the patients receiving it.

Pivotal Health exists to fix that. We build technology that helps hospital-based providers get paid fairly for the care they provide, while protecting patients from surprise medical bills. Our platform guides providers through the highly complex No Surprises Act dispute process, turning what was once manual, risky, and inconsistent into a structured, data-driven workflow.

With a rapidly growing customer base, strong revenue momentum, and a mission rooted in fairness and transparency, Pivotal is helping modernize one of healthcare’s most critical—and overlooked—systems.

About the Role

Pivotal Health is looking for a Client Strategy and Operations Manager to own the operational and strategic engine behind our most complex client relationships- large health systems and hospitals. You’ll manage a portfolio of high-value enterprise pods, serving as the strategic and technical owner of how those clients are operated against day-to-day. 

You’ll combine deep data fluency, hands-on technical ownership, and senior client presence to surface issues before clients raise them, turn operational signal into client-facing strategy, and design the playbooks the rest of the team uses as we scale. This is a high-impact, hands-on role at a high-growth startup where your operating decisions will shape how Pivotal scales into the hospital and health system segment. This is an individual contributor role, not a managerial role. 

Responsibilities

• 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.

#Perks

• Competitive compensation, including equity: 
• 80,000-90,000
• Full health, dental, and vision coverage
• Retirement savings plan through 401(k)
• Flexible time off
• Opportunities for company-wide connection and events