About the RoleAt Commure, our Revenue Cycle Management (RCM) AI team is building the autonomous backend that turns healthcare's most manual financial workflows into intelligent systems. The LCS (Claims Submissions) team owns getting claims out the door correctly, the first time. It is in front of the entire revenue cycle: nothing else downstream matters if we can't reliably translate a clinical encounter into a clean, payer-accepted claim.
What You'll Do- Design a pre-submission validation engine and self-service override flow that lets ops unblock sites in minutes instead of waiting on a PR, review, and deploy.
- Tame payer heterogeneity: encode hundreds of payer-specific behaviors (POS overrides, frequency codes, subscriber/dependent hierarchy, NDC and CLIA handling) into validation rules and configuration instead of bespoke code, so each new customer launch gets cheaper than the last.
- Make secondary and tertiary claims reliable: detect and recover claims stuck in verification, get line-level adjudication matching right, and choose the correct submission method per payer.
- Build the Eligibility Orchestrator's routing logic so the right payer gets the right claim, with guardrails that prevent acting on a coverage result that belongs to the wrong person.
- Build a payer-specific EDI regression suite that breaks the fix-break-fix cycle on clearinghouse quirks.
- 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
What You Have- 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 Javascript, HTML, CSS
- Proficiency in backend languages like Python, Go, or C++.
- 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.
