Senior Software Engineer, Claims Submissions
Senior engineer on the Claims Submissions team building the autonomous backend for healthcare revenue cycle management. Owns pre-submission validation, payer-specific rules, EDI regression, and end-to-end claim reliability.
About the job
What You’ll Do
- Design a pre-submission validation engine and self-service override flow that lets ops unblock sites in minutes instead of waiting on a PR, review, and deploy.
- Tame payer heterogeneity: encode hundreds of payer-specific behaviors (POS overrides, frequency codes, subscriber/dependent hierarchy, NDC and CLIA handling) into validation rules and configuration instead of bespoke code, so each new customer launch gets cheaper than the last.
- Make secondary and tertiary claims reliable: detect and recover claims stuck in verification, get line-level adjudication matching right, and choose the correct submission method per payer.
- Build the Eligibility Orchestrator's routing logic so the right payer gets the right claim, with guardrails that prevent acting on a coverage result that belongs to the wrong person.
- Build a payer-specific EDI regression suite that breaks the fix-break-fix cycle on clearinghouse quirks.
- Contribute to the technical direction of the RCM platform by proposing and implementing improvements to architecture, tools, and technologies.
- Build end-to-end products to revolutionize revenue cycle management for providers and administrators.
- Take ownership of end-to-end integration workflows, from design and development through to deployment and post-launch monitoring.
- Collaborate with cross-functional teams (product, engineering, and healthcare) to gather integration requirements, define technical approaches, and prioritize tasks based on business needs.
- Mentor and guide engineers, fostering a culture of technical excellence and continuous learning.
- Conduct in-depth code reviews, uphold best practices, and drive architectural improvements across the stack.
What You Have
- Bachelor’s or Master’s degree in Computer Science, Engineering, or a related field, or equivalent extensive experience.
- 5+ years of professional software development industry experience.
- Proficiency in frontend languages like Javascript, HTML, CSS.
- Proficiency in backend languages like Python, Go, or C++.
- Experience including but not limited to Git, GCP / AWS, Docker, Kubernetes, relational and non-relational DBs, and monitoring/alerting tools.
- Proven track record of designing and implementing end-to-end solutions and making successful architectural decisions.
- Excellent communication and collaboration skills, with the ability to work in a fast-paced, dynamic environment.
Skills
JavaScript, HTML, CSS, Python, Go, C++, Git, GCP, AWS, Docker, Kubernetes, Relational Databases, Non-Relational Databases
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