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, starting from the initial generation of structured claim payloads to the final submission through multiple clearinghouses. This role involves integrating with various clearinghouses, handling their responses, verifying eligibility, and scaling a rule engine to ensure claims are routed appropriately.

Responsibilities

• Clearinghouse integrations: Submitting claims through multiple clearinghouses and managing their heterogeneous responses, verification, and error semantics.
• Claim generation pipeline: Transforming structured claim payloads into valid electronic EDI claims across different formats (professional, institutional, dental).
• Eligibility Orchestrator: Designing routing logic to ensure claims are directed to the correct payer and preventing incorrect coverage results.
• Rule engine implementation: Building a scalable rule engine that executes hundreds of configurable conditions and actions per customer, ensuring safety, idempotence, and full explainability.
• Technical leadership: Contributing to the technical direction of the RCM platform, proposing and implementing improvements to architecture, tools, and technologies.
• Product development: Building end-to-end products to transform revenue cycle management for providers and administrators.
• Integration workflow management: Taking ownership of end-to-end integration workflows, from design and development through to deployment and post-launch monitoring.
• Collaboration: Working with cross-functional teams to gather requirements, define technical approaches, and prioritize tasks based on business needs.
• Mentoring: Guiding engineers to foster a culture of technical excellence and continuous learning.
• Code review: Conducting in-depth code reviews, upholding best practices, and driving 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).
• Strong problem-solving skills and ability to work independently and as part of a team.

Skills

• Software development skills in TypeScript, React, Python, or Go.
• Experience with cloud platforms (GCP / AWS).
• Knowledge of database technologies (relational and non-relational).
• Experience with CI/CD pipelines and automation tools.
• Experience with EDI standards and healthcare data formats.

Benefits

• Competitive compensation range: $170K - $240K.
• Healthcare benefits package.
• Flexible work schedule.
• Professional development opportunities.
• Work alongside a passionate and innovative team.

Pay

• $170K - $240K

Schedule

• Full-time