Staff Software Engineer, Accounts & Ledgering

About the role

We're hiring a Staff Software Engineer to own the accounts and ledgering spine of our RCM platform. This is the path from "insurance paid us" to "the books balance, the patient knows what they owe, and leadership can trust the numbers."

Responsibilities

• Design the next-generation account and ledger model, immutable events, derived balances, clear semantics around payer balance vs. patient balance vs. adjustments vs. cash, with invariants that make it structurally impossible to "print money"
• Keep operational balances and financial reports in lockstep. Posting, adjustments, patient balances, rollups, and balance reports need to agree. When they don't, we need drift detection and self-healing
• Reconcile three (or four) sources of truth: billed charges, payer remittances, bank deposits, and financial reports. Surface discrepancies before customers do
• Scale idempotent, explainable posting and adjustment pipelines across high transaction volumes using negation/reversal semantics instead of mutable edits
• Operate money-critical systems on very large Postgres tables, safe migrations, trigger-driven projections, backfills, observability, and incident response where "eventually consistent" isn't acceptable
• Set the bar for observability and operational readiness (monitoring, logging, distributed tracing, dashboards, alerting, SLOs, and safe production rollouts) and make sure the team actually lives by it
• Work hand-in-hand with platform and product teams to keep sensitive customer data protected, tighten security boundaries, and stay on top of our regulatory and compliance obligations
• Own complex, cross-system initiatives end to end: architecture and design, implementation, migration, rollout, and everything that comes with running it in production
• Mentor Senior and Staff engineers, run architecture and design reviews, and push the technical bar higher through clear direction, strong engineering habits, and honest feedback
• Make pragmatic calls that weigh security, correctness, reliability, performance, and simplicity against how fast we need to ship
• Spot systemic risks early and fix the root cause instead of patching around it

Requirements

8+ years building software, with a track record of Staff-level work, architecture ownership, mentoring, cross-team influence

Strong backend engineering (Python preferred) and deep experience with relational databases at scale: query performance, ACID transactions, safe migrations, data integrity

Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history

Real experience shipping production systems with observability, alerting, and incident response practices, especially for high-stakes workflows

Strong communication and collaboration skills. You can work with ops and customers when correctness matters

Bonus points if you have Healthcare RCM, patient accounting, insurance remittance (835/ERA), AR aging, or practice-management billing

File-based integrations, bank reconciliation, event-sourced/CDC architectures, or high-throughput batch pipelines

Qualifications

Experience evolving a monolith toward clearer domain boundaries or event-oriented model

Skills

None listed

Benefits

N/A

Pay

$210K - $275K

Schedule

N/A