Senior Software Engineer, Claims Submissions
Build claim generation pipeline for CMS-1500, CMS-1450, and CDT formats
Transform structured claim payloads into valid electronic EDI claims across professional, institutional, and dental formats. Handle clearinghouse integrations, including submission, verification, and error semantics. Build eligibility orchestrator routing logic to ensure correct payer routing with guardrails against mismatched coverage.
Why This Role?
Direct impact on patient care with immediate feedback from clinician collaboration
Key Responsibilities
- Submit claims through multiple clearinghouses and manage heterogeneous responses and error handling
- Transform structured claim data into valid EDI formats for CMS-1500, CMS-1450/UB, and CDT claim types
- Generate paper claims and PDFs for payers requiring mail or fax submission
- Develop routing logic for the Eligibility Orchestrator to direct claims to the correct payer
- Implement guardrails to prevent acting on eligibility results belonging to the wrong patient
- Scale rule-based systems for claim processing reliability and throughput
Requirements
- Experience with healthcare claims processing and EDI formats (CMS-1500, CMS-1450, CDT)
- Proficiency in building and integrating with clearinghouse systems
- Strong background in backend systems for revenue cycle management or financial workflows
- Experience designing routing logic with validation guardrails in healthcare contexts
- Familiarity with scaling rule engines for high-volume transaction processing
Required Skills
Indonesia Context
- Working Hours Overlap:
- Minimal overlap — opposite hours
Keywords
View Original Description from Ashby Job Boards
Original description from Ashby Job Boards
At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs. Healthcare carries a $1 trillion administrative burden and we're at the center of transforming it. Today, 500,000+ clinicians across 500+ healthcare organizations nationwide trust Commure to handle $25B+ in annual claims and support over 200 million patient interactions. Our latest $70M raise at a $7B valuation reflects the confidence the market has placed in this mission. We've also been named to the Fortune Future 50 list and the 2026 AI Breakthrough Awards for “Overall NLP Company of the Year.” Our team works directly alongside clinicians, not through layers of process, which means the gap between what you build and its impact on patient care is immediate. We move fast, deploy daily, and take full ownership from early thinking to production. If you're energized by hard problems, high stakes, and a team that holds itself to a high bar, you'll find your people here. The future of healthcare is being built right now. Come deliver this transformation. About the Role At Commure, our Revenue Cycle Management (RCM) Core team is building the autonomous backend that turns healthcare's most manual financial workflows into intelligent systems. The 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 - Clearinghouse integrations: submitting claims through multiple clearinghouses and handling their heterogeneous response, verification, and error semantics. - The claim generation pipeline: transforming structured claim payloads into valid electronic EDI claims across professional (CMS-1500), institutional (CMS-1450/UB), and dental (CDT) formats, plus paper-claim and PDF generation for payers that require mail or fax. - 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. - 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. - 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 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. Please be aware that all official communication from us will come exclusively from email addresses ending in @getathelas.com http://getathelas.com, @commure.com http://commure.com or @augmedix.com http://augmedix.com. Any emails from other domains are not affiliated with our organization. Employees will act in accordance with the organization’s information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. Employees will be required to attest to these requirements upon hire and on an annual basis.
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Frequently asked questions
- Is Senior Software Engineer, Claims Submissions at Commure a remote job?
- This role is based in Remote. See the listing for remote/onsite details.
- What is the salary for Senior Software Engineer, Claims Submissions at Commure?
- The listed pay range for this role is $170k–240k/yr.
- What type of employment is Senior Software Engineer, Claims Submissions at Commure?
- This is a full time position.
- How do I apply?
- Click the "Apply" button on this page to go to the official application at Commure.
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