Senior Software Engineer, Claims Intelligence

About the Role

At Commure, our Revenue Cycle Management (RCM) Core team is building the autonomous backend that turns healthcare's most manual financial workflows into intelligent systems. The Claims Submissions team owns getting claims out the door correctly, the first time. It is in front of the entire revenue cycle: nothing else downstream matters if we can't reliably translate a clinical encounter into a clean, payer-accepted claim.

What You'll Do

• Clearinghouse integrations: Submitting claims through multiple clearinghouses and handling their heterogeneous response, verification, and error semantics.
• The claim generation pipeline: Transforming structured claim payloads into valid electronic EDI claims across professional (CMS-1500), institutional (CMS-1450/UB), and dental (CDT) formats, plus paper-claim and PDF generation for payers that require mail or fax.
• Eligibility routing: 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.
• Rule engine scaling: Scale a rule engine that runs hundreds of configurable conditions and actions per customer across high transaction volumes — safely, idempotently, and with full explainability for operations teams.
• Architecture & Technical Direction: Contribute to the technical direction of the RCM platform by proposing and implementing improvements to architecture, tools, and technologies.
• Product Development: Build end-to-end products to revolutionize revenue cycle management for providers and administrators.
• Integration Workflows: Take ownership of end-to-end integration workflows, from design and development through to deployment and post-launch monitoring.
• Cross-functional Collaboration: Collaborate with cross-functional teams (product, engineering, and healthcare) to gather integration requirements, define technical approaches, and prioritize tasks based on business needs.
• Mentorship & Quality: Mentor and guide engineers, 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 TypeScript and React
• Proficiency in backend languages like Python or Go
• 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

Security Requirements

Employees will act in accordance with the organization’s information security policies, protecting assets from unauthorized access, disclosure, modification, destruction, or interference. Employees will report confirmed or potential events to the information security office and attest to these requirements upon hire and annually.