Director of Solution Architecture

The core responsibilities for the job include the following:

Own the Strategic Account:

• Own the billing and revenue cycle workstream on a named book of enterprise accounts, from signature through go-live and steady state.
• Act as the senior revenue cycle counterpart to the client, billing managers, operations leaders, and finance.
• Monitor account billing health continuously: first-pass yield, denial mix, days in A/R, and net collection rateand drive root causes to resolution.
• Run structured reviews with client leadership, tying billing performance to their financial outcomes.

Lead the Implementation:

• Design and drive the billing setup for each account: payer matrices, state-specific billing rules, fee schedules, and credentialing dependencies.
• Own EDI and ERA enrollment sequencing and clearinghouse configuration through to clean claim submission.
• Sequence multi-site, multi-state rollouts in batches, working through the onboarding and billing operations teams.
• Convert each implementation into reusable payer rule libraries, config templates, and playbooks so the next one is faster.

Enterprise Deals and Pre-Sales:

• Serve as the revenue cycle expert in enterprise pursuitsRFP responses, billing deep dives, and discovery with prospective clients.
• Scope what we can realistically deliver, and validate billing commitments before they reach a contract.
• Hand requirements cleanly to onboarding so they are captured once, not relitigated with the client.
• Equip the sales team with clear, accurate answers on billing and RCM capability.

Product and Payer Intelligence:

• Translate enterprise client needs into product requirements; claim edits and NCCI logic, modifier handling, 8-minute-rule unit calculations, CMS-1500 and UB-04 behavior, therapy threshold tracking, claim scrubbing, ERA posting, and remit reconciliation.
• Track CMS proposed and final rules, MPFS updates, MIPS, and RTM, and translate them into roadmap implications ahead of client demand.
• Identify recurring denial patterns across accounts and get them fixed at the source rather than worked case by case.
• Contribute to the internal billing knowledge base so the wider team can answer confidently without escalation.

Requirements:

• 12-16 years in the US healthcare revenue cycle, including ownership of enterprise or multi-site implementations.
• Strong hands-on US outpatient revenue cycle background; professional (Part B) billing, commercial and Medicare/Medicaid, denials and appeals.
• Track record leading billing implementations for large US provider groups across multiple sites, states, and payers.
• Working knowledge of EDI: 837 835 270/271 277CA, payer enrollment, ERA setup, and rejection triage.
• Excellent spoken and written English, with the confidence to run business conversations with US clinic owners and finance leadership independently.
• Comfortable delivering through cross-functional teams rather than a direct reporting line.
• Comfortable working a shift that overlaps with US Eastern hours.
• Data-driven working style: you pull your own reports, spot the pattern, and act before being asked.