Senior Software Engineer, Claims Submissions

About the role

The Claims Submissions team at Commure is responsible for ensuring that claims are submitted correctly and efficiently, with a focus on reliability and accuracy. This role involves integrating with various clearinghouses, generating claims in different formats, and managing eligibility processes.

Responsibilities

• Clearinghouse integrations: submitting claims through multiple clearinghouses and handling their responses, verification, and error semantics.
• The claim generation pipeline: transforming structured claim payloads into valid electronic EDI claims across professional, institutional, and dental formats, plus paper-claim and PDF generation.
• Build the Eligibility Orchestrator's routing logic to ensure claims are routed to the correct payer and prevent incorrect coverage results.
• Scale a rule engine that handles hundreds of configurable conditions and actions per customer, ensuring safety, idempotence, and full explainability for operations teams.
• 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 transform 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 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.

Requirements

• 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 with Git, GCP / AWS, Docker, Kubernetes, relational and non-relational databases, 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.

Qualifications

• Experience with healthcare IT systems and understanding of revenue cycle management processes.
• Knowledge of healthcare regulations and compliance standards.
• Experience with healthcare-specific data formats and standards (e.g., CMS-1500, CMS-1450/UB, CDT).
• Experience with healthcare-specific claims submission processes and requirements.

Skills

• Strong problem-solving skills.
• Experience with healthcare-specific claims submission processes and requirements.
• Ability to work in a fast-paced, dynamic environment.
• Experience with healthcare-specific data formats and standards (e.g., CMS-1500, CMS-1450/UB, CDT).

Benefits

Commure offers a competitive compensation range of $170K - $240K, along with comprehensive benefits including health insurance, retirement plans, and paid time off.

Pay

$170K - $240K

Schedule

Full-time