Director of Underwriting

Job Description

Job Description

About Us

At Office Ally, we've been revolutionizing healthcare administration since our inception. What started as a clearinghouse focused on simplifying insurance claims processing for healthcare providers has grown into a full-suite healthcare technology company. We offer a range of affordable, cloud-based revenue cycle management solutions –from eligibility verification and claims management to revenue recovery and payment processing –that help healthcare organizations of all sizes streamline operations and reduce administrative burdens so they can focus on what matters most: patient care.

In April 2026, Office Ally acquired Jopari Solutions, Inc, a leader in straight-through electronic claims processing for Property & Casualty (P&C), Commercial, and Government healthcare. Jopari brings deep industry expertise and innovative enterprise payment solutions that are transforming how disbursements are handled across the insurance ecosystem. Together, we are expanding our capabilities across the full healthcare transaction lifecycle, connecting claims, payments, and data exchange to deliver a more seamless and efficient experience for providers, payers, and partners.

At the core of our company are four key values that guide our mission and work:

• Ownership : We take pride in our responsibilities, driving results and taking accountability for the success of our projects.
• Empowerment : We believe in giving our team the autonomy and support to make decisions that lead to innovative solutions.
• Innovation : We continuously seek new and better ways to improve healthcare administration, embracing creativity and forward-thinking technology.
• Transparent Communication : Open, honest communication is at the heart of our collaborations, internally and with our clients, ensuring alignment and trust.

About the Role

Office Ally is hiring our first Director of Underwriting to build and run the credit function for OA Advance, our new working capital product. Reporting to the SVP and GM of Payments, this is a high-impact, high-autonomy founding role with full ownership of underwriting policy, decisioning, portfolio monitoring, and the operational discipline required to extend working capital responsibly and profitably.

OA Advance evaluates submitted insurance claims for likelihood of payment and advances a percentage of expected reimbursement directly to the practice's bank account. When the payer remits payment and sends an 835, we auto-recoup the advance plus program fees. The program combines proprietary clearinghouse data, machine learning, and embedded finance to solve one of the most persistent cash flow problems in healthcare.

This role is ideal for a pragmatic, business-oriented credit professional who thrives building a function from zero, enjoys working at the intersection of healthcare revenue cycle and commercial lending disciplines, and wants to be deeply embedded in the operations of a growth-stage healthcare technology company.

What You'll Do

Underwriting Decisions & Workflow

• Own the practice-level underwriting decision for OA Advance applicants — auto-approve oversight, manual review queue, etc.
• Configure and operate the underwriting workbench, including bureau pulls, UCC searches, OFAC screening, KYB verification, and continuous monitoring alerts.
• Establish and maintain the manual review playbook, decision documentation standards, and audit trail practices required to scale the program responsibly.

Policy Ownership & Calibration

• Take ownership of the underwriting policy and pressure-test every threshold against historical Office Ally clearinghouse data.
• Lead quarterly policy reviews; recommend threshold adjustments based on vintage analysis.
• Partner with the AI/ML team to refine the practice-level risk score and validate weights against portfolio performance.

Portfolio Monitoring & Risk Management

• Establish vintage analysis, concentration monitoring, and active portfolio monitoring processes.
• Monitor portfolio-level KPIs including approval rate, auto-decision rate, default rate, loss given default, and time-to-decision.
• Triage continuous monitoring alerts (UCC filings, NPI status changes, claim volume drops, denial rate increases).
• Identify policy and process gaps proactively — before regulators or losses do.

Compliance & Regulatory

• Serve as the credit officer of record for OA Advance — the person who can defend a decision in front of an auditor, an examiner, or an executive.
• Partner with Legal and Compliance on fair lending, disparate impact testing, and the PHI firewall between underwriting data and patient clinical data.
• Own the audit-readiness posture for the function: documented policy, immutable decision logs, reason code mapping, and reviewer accountability.

Vendor, Platform & Cross-Functional Partnership

• Manage the relationship with the underwriting platform vendor (TBD selected partner), including SLA performance, monitoring rule customization, and renewal terms.
• Partner closely with the AI/ML team (claim-level scoring), Infrastructure team (data pipeline and rules engine), Product (program economics), and Sales/Operations (applicant pipeline).
• Translate underwriting performance and risk posture into clear executive-level reporting.

What You'll Need

• 7+ years of underwriting experience, with at least 3 years in commercial, asset-based, factoring, or specialty business credit (not exclusively consumer).
• Demonstrated ownership of a credit policy — you have written one, defended it, and revised it based on portfolio performance.
• Working knowledge of ECOA / Regulation B, FCRA, OFAC screening, and adverse action requirements.
• Fluency with the Expected Loss framework (PD × LGD × EAD) and the ability to translate it for non-credit stakeholders.
• Hands-on experience operating an underwriting platform end-to-end (MidDesk, TurnKey Lender, HES LoanBox, or comparable factoring/lending workbench).
• Comfort with data: you can pull a query, read a model output, and challenge a data scientist on whether a score makes sense.
• Excellent written communication — you will be writing policy, decision rationales, and executive memos.
• Highly organized, self-directed, and comfortable building a function from zero rather than inheriting a mature one.
• Problem-solving skills and a business-practical mindset are paramount.

Nice to Have

• Bachelor's degree
• Direct healthcare experience: 837/835 transaction sets, ERA reconciliation, payer mix analysis, denial code taxonomy, and the NPI registry.
• Experience underwriting medical practices or healthcare receivables specifically (e.g., at a medical factor or healthcare fintech).
• Familiarity with UCC Article 9, security interests in healthcare receivables, and Medicare/Medicaid anti-assignment rules.
• Prior role in a startup, new product launch, or "founding underwriter" capacity — comfort with ambiguity.
• Track record of building and managing a small underwriting team.
• Prior experience in a PE-backed or growth-stage company environment.

Travel Requirements

• This role requires travel up to 4x per year, which may include vendor visits, team gatherings, industry conferences, or company events.
• Travel will typically be scheduled in advance and supported by the company.

Pay Transparency

Office Ally is committed to fair and equitable compensation practices in alignment with pay transparency laws. Compensation for this position may vary based on individual skills, experience, and location. In addition to base pay, employees may be eligible for performance-based bonuses and a comprehensive benefits package, including medical, dental, and vision coverage, 401(k) with company match, paid time off, and other benefits. Actual compensation will be determined considering the candidate's qualifications, relevant experience, and internal equity.

Office Ally Pay Transparency

$165,000—$180,000 USD

Why You'll Love Working at Office Ally

At Office Ally, your work has a direct impact on healthcare providers and their ability to deliver exceptional care. We're driven by a mission to simplify healthcare administration, making it easier for providers to focus on what they do best—helping patients. As an Office Ally employee, you'll be at the heart of our efforts to deliver exceptional service and software solutions to our clients in the healthcare space.

EEO Note

Office Ally is an Equal Opportunity Employer and does not discriminate against any employee or applicant on the basis of age, color, disability, gender, national origin, race, religion, sexual orientation, veteran status, or any classification protected by federal, state, or local law.