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 claim routing.

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's routing logic: ensuring the right payer receives the correct claim, with safeguards against incorrect assignments.
• Rule engine implementation: configuring and running hundreds of conditions and actions per customer, ensuring safe, idempotent, and explainable operations.
• Technical direction: contributing to the platform's architecture, tools, and technologies, and implementing improvements.
• 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 based on business needs.
• 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.
• Knowledge of HIPAA compliance and data privacy regulations.
• Understanding of healthcare reimbursement models and processes.

Skills

• Strong problem-solving and analytical skills.
• Experience with healthcare-specific APIs and systems.
• Ability to work independently and as part of a team.

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