Senior Backend Software Engineer

TL;DR

Senior Backend Software Engineer (Healthcare): Building reliable abstraction layers over fragmented healthcare systems with an accent on AI-enabled clinical systems, insurance billing engines, and financial integrity. Focus on designing high-integrity clinical data systems, scaling payer-specific billing workflows, and ensuring strict consistency in multi-party ledger systems.

Location: New York, NY; San Francisco, CA; Seattle, WA, United States

Salary: $168,300 - $237,500 base salary plus equity

Company

Series D mental health platform with $325M+ funding, automating insurance credentialing, claims, and practice management for 70,000+ providers across all 50 US states.

What you will do

• Design and build AI-enabled clinical systems for storing treatment plans, progress notes, patient history, and generating session summaries.
• Scale insurance billing engines handling complex payer rules, claims estimation, and filing for hundreds of thousands of claims monthly.
• Develop patient-first backend services for personalized care recommendations, health tracking, and therapist matching.
• Build ledger systems ensuring accurate payments for 70,000+ providers with idempotency and strict consistency.
• Collaborate across teams to own outcomes from ambiguous problems to shipped software.

Requirements

• Location: Based in New York, San Francisco, or Seattle offices
• Experience owning ambiguous problems and shipping maintainable, scalable software.
• Proven ability to set technical standards, mentor engineers, and improve team velocity.
• Quick learner in complex domains like healthcare regulations and payers.
• Strong communication skills for design docs, code reviews, and cross-team alignment.
• Hands-on experience tinkering with AI/LLMs for code generation, automation, or workflows.

Culture & Benefits

• Comprehensive medical, dental, vision, HSA/FSA, 401(k), and 16-week parental leave.
• Flexible PTO, 13 holidays, full week off in December, therapy reimbursement, and professional development budget.
• Competitive equity package and focus on meaningful impact in mental healthcare.
• Tools like Cursor, Claude, Gemini for AI-assisted development.

Hiring process

• Initial screen with recruiting to discuss background and mission.
• First round: Live coding with engineer.
• Final rounds: Technical and non-technical interviews with team members.
• References and offer with equity details.