Senior Full Stack Software Engineer RCM

Job Description

Job Description

Senior Fullstack Engineer, Revenue Cycle – Series B Health Tech

New York, NY (SoHo) · Hybrid, 3+ days on-site · Full-time

About the company

Our client is a venture-backed health tech company building the software platform that modern musculoskeletal (MSK) practices run on. It partners with MSK provider groups and specialty clinics to help them grow, run more efficiently, and deliver better longitudinal care, from the first patient touchpoint through clinical workflows, billing and ongoing engagement.

The company recently closed its Series B with a top-tier venture firm and is now growing the engineering team that builds the product clinics run on every day.

The role

You'll join a two-person pod that owns revenue cycle management (RCM) for MSK clinics: everything from eligibility checks and pre-visit clearance through claims, remittance and payment. Getting this right means clinics get paid for the care they deliver, and patients aren't surprised by a bill.

The core of the job is turning messy billing operations into automated, auditable workflows. Every claim and payment moves through a state machine. Rules are configurable, so a new payer edge case doesn't require new code. And the billing and ops teams get internal tools that show them exactly where every dollar stands.

You'll work end to end in one TypeScript monorepo: Vue on the frontend, Node/Express and MongoDB behind it, and Temporal for durable workflows. API schemas are declared once and both sides typecheck against them, so a broken endpoint fails the build instead of reaching a biller.

We want someone who treats revenue cycle as a domain to understand deeply, not a queue of tickets. Payers are inconsistent, remittance data is messy, and the edge cases are the job. If that sounds interesting rather than annoying, keep reading.

What you'll do

• Build and own revenue cycle workflows end to end: eligibility, pre-visit clearance, claims, remittance and payment posting
• Model claims and payments as explicit, auditable state machines, so every status change is traceable
• Design configurable rules that handle payer-specific logic without new code for every case
• Orchestrate long-running billing processes with durable workflows (Temporal)
• Build internal tools that give billing and ops teams a clear view of every claim and dollar
• Design APIs contract-first, with schemas shared across frontend and backend
• Model financial and patient data in MongoDB, and keep it accurate and fast as volume grows
• Take features from spec to production, and support them once they're live

What we're looking for

• 5+ years building and shipping production web applications, owning features end to end as a senior engineer
• Strong TypeScript on both the frontend and the backend
• Vue 3 or React, plus Node and Express
• MongoDB at scale: schema design, indexing, and knowing what your queries cost
• Domain depth in healthcare revenue cycle or fintech/payments: claims, eligibility, remittance, ledgers or payment processing
• You've built stateful, auditable transaction workflows: state machines, rules engines or reconciliation systems
• Startup or growth-stage experience. You're high-agency, you ship, and you go after hard problems without waiting for a perfect spec
• You can explain a past design decision you'd make differently now, and why

No healthcare background? If you've built payments, ledgers or reconciliation in fintech, we want to hear from you. The transaction problems are the same; the domain can be learned.

Nice to have

• EDI X12 transactions, especially 270/271 (eligibility) and 835 (remittance)
• Background at an RCM, clearinghouse or practice-management company
• Temporal or other durable workflow orchestration (Cadence, AWS Step Functions)
• HL7, FHIR or EHR integration exposure
• Analytics on transactional data (ClickHouse, Databricks)
• Monorepo experience (Turborepo, Nx)

Where and how we work

• Location: New York office in SoHo. This role is hybrid, with at least 3 days a week on-site
• Collaboration: we pair often and keep cameras on for team syncs, pairing sessions and technical discussions
• Team: a small, focused pod inside a growing engineering team, so you'll have real ownership of how revenue cycle is built

Compensation and how to apply

Base salary: $190,000 to $240,000, plus equity. The final offer depends on experience and skills.

This search is being run by INNOVA People.

Our client is an equal opportunity employer. We welcome applicants of every background and do not discriminate on the basis of any protected characteristic.