Senior Software Engineer, Rejections & Denials
Commure · Los Angeles, CA · 5 days ago
HybridEngineering$170k–$240k/yrFull-time
About the role
The Rejections & Denials team at Commure is responsible for building the AI and rules infrastructure that fixes claims autonomously. This team transforms repetitive human work into auditable, automated workflows.
Responsibilities
- Build LLM-powered automation that decides how to fix a denied claim, with evals, dry runs, and audit trails rigorous enough to let it act autonomously on real money.
- Design guardrails that keep automation safe: identity guards, payer-type guardrails (dental, Medicare A vs. B), duplicate-prevention, and dry-run / QA gates before anything touches production.
- 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.
- Generate appeal letters and medical-record packets automatically, with validation scoring that decides what's safe to send unattended.
- Build the observability that turns a long tail of edge cases into a prioritized roadmap: dashboards for automated resubmission approval rate, denial-to-resubmission cycle time, and failure rates broken down by insurance type, denial category, and site.
- Deliver a unified automations console where ops can see and manage every rule engine (billing rules, pre-submission validation, adjustments) in one place.
- 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 revolutionize 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 (product, engineering, and healthcare) 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
Required qualifications include:
- 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.