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. This role involves integrating with clearinghouses, generating valid electronic EDI claims, and scaling a rule engine to handle complex eligibility and workflow scenarios.

Responsibilities

• Clearinghouse integrations: submitting claims through multiple clearinghouses and handling their heterogeneous response, verification, and error semantics.
• Claim generation pipeline: transforming structured claim payloads into valid electronic EDI claims across various formats.
• Eligibility Orchestrator: routing logic to ensure the right payer receives the correct claim, with guardrails to prevent incorrect processing.
• Rule engine implementation: configuring and running hundreds of conditions and actions per customer, ensuring safety, idempotence, and explainability.
• Technical direction: proposing and implementing improvements to the RCM platform's architecture, tools, and technologies.
• End-to-end product development: creating revolutionary solutions for revenue cycle management.
• Integration workflows: designing, developing, deploying, and monitoring end-to-end integration processes.
• Collaboration: working with cross-functional teams to gather requirements, define technical approaches, and prioritize tasks.
• Mentoring: guiding engineers to foster a culture of technical excellence and continuous learning.
• Code reviews: conducting thorough code reviews, upholding best practices, and driving architectural improvements.

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-specific systems and workflows.
• Strong understanding of healthcare regulations and compliance standards.
• Knowledge of healthcare IT systems and terminology.

Skills

• Software development skills in TypeScript, React, Python, or Go.
• Experience with cloud platforms (GCP / AWS).
• Knowledge of EDI standards and claim submission processes.
• Experience with database management and query optimization.
• Ability to work with healthcare data and understand its nuances.
• Experience with CI/CD pipelines and automation tools.

Benefits

• Competitive compensation range: $170K - $240K.
• Flexible work schedule.
• Professional development opportunities.
• Healthcare benefits package.
• Work-life balance initiatives.

Pay

• $170K - $240K

Schedule

• Full-time position.