Staff Accountant , Payroll

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

We’re looking for a Staff Accountant to join our growing Accounting team to manage AP and Payroll. As Pivotal Health transitions off our PEO and onto Rippling for payroll processing, we need someone who can support that transition and own the accounting and operational work that comes with it.

Rather than a payroll-only hire, we’re looking for someone stronger on the accounting side who can process payroll accurately and reliably, who will own accounts payable, company credit cards and employee reimbursements, support our benefit plans, and help with month-end close and cash management.

This is a great fit for someone with an accounting background who has hands-on experience with both AP and payroll, and who’s comfortable working in a fast-paced, evolving environment.

What You’ll Do

Process accounts payable end-to-end, including reviewing and coding invoices for accuracy

Process payroll each cycle and ensure accuracy across pay runs, partnering with Rippling on tax and compliance filings

Manage the company credit card program and employee reimbursements in Ramp

Support administration of benefit plans as we transition off our PEO

Assist with month-end close and other accounting close activities

Support cash management and other day-to-day accounting operations

Partner with People Ops on payroll-related questions and processes

Help ensure a smooth transition as we bring payroll and benefits fully in-house

Who You Are

Bachelor’s degree in Accounting, or 5+ years of accounts payable and payroll experience across different environments

3–5+ years of experience processing accounts payable and payroll

Experience with Rippling strongly preferred (comparable platforms such as Workday considered)

Experience with Ramp preferred (comparable platforms such as Brex or Bill.com considered)

Solid understanding of AP coding and core accounting fundamentals

Comfortable working in a fast-paced, evolving environment; startup experience a plus

Extra Credit if you have it:

Direct experience with Rippling

Direct experience with Ramp

Experience helping a company transition off a PEO

Startup experience

Experience supporting month-end close processes

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.