Staff Software Engineer, Accounts & Ledgering

San Francisco, Los Angeles + 1 more
Full-time

About the role

What we're looking for:

We need a Staff Software Engineer with 8+ years of experience building backend systems and 3+ years designing and operating financial systems from 0-to-1. We're looking for someone who has built a double-entry payment ledger that has deep expertise in accounts and ledgering — payments, billing, reconciliation, ledgers, or accounting. You should be comfortable owning the full architecture of money-critical systems at scale and have a track record of designing immutable, event-oriented data models where correctness is non-negotiable. Bonus points if you have healthcare RCM, insurance remittance (835/ERA), or bank reconciliation experience.

What you'll do:

  • Design and operate a double-entry payment ledger and the next-generation account and ledger model — immutable events, derived balances, and clear semantics around payer balance vs. patient balance vs. adjustments vs. cash, with invariants that make it structurally impossible to "print money"
  • Take ownership of the full money path: insurance ledger, posting/adjustment engines, patient account ledgers, bank reconciliation, and reporting/AR
  • Reconcile multiple sources of truth — billed charges, payer remittances, bank deposits, and financial reports — and 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 with 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
  • Mentor Senior and Staff engineers, run architecture and design reviews, and push the technical bar higher through clear direction and honest feedback
  • Own complex, cross-system initiatives end to end: architecture, implementation, migration, rollout, and production operations

About Commure

At Commure, our mission is to simplify healthcare. We have bold ambitions to reimagine the healthcare experience, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans ambient AI clinical documentation, provider copilots, autonomous coding, revenue cycle management and more — all designed for providers & administrators to focus on what matters most: providing care.

Healthcare is a $4.5 trillion industry with more than $500 billion spent annually on administrative costs, and Commure is at the heart of transforming it. We power over 500,000 clinicians across hundreds of care sites nationwide – more than $10 billion flows through our systems and we support over 100 million patient interactions. With new product launches on the horizon, expansion into additional care segments, and a bold vision to tackle healthcare's most pressing challenges, our ambition is to move from upstart innovator to the industry standard over the next few years.

Commure was recently named to Fortune’s Future 50 list for 2025 and is backed by world-class investors including General Catalyst, Sequoia, Y Combinator, Lux, Human Capital, 8VC, Greenoaks Capital, Elad Gil, and more. Commure has achieved over 300% year-over-year growth for the past two years and this is only the beginning. Healthcare's moment for AI-powered transformation is here, and we're building the technology to power it. Come join us in shaping the future of healthcare.

Required skills

Python
PostgreSQL
Event-Driven Architecture
SQL
REST APIs
Distributed Tracing
CDC (Change Data Capture)
Bank APIs
BAI2
OCR

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Job details

Salary

$250,000 - $300,000

Location

San Francisco, Los Angeles + 1 more

Experience

8+ years

Company

NameCommure
Industryai, healthcare
Team Size1200

Funding

Total raised

$753M

Last stage

Growth

Investors

General Catalyst
GGreenoaks Capital
Human Capital
8VC
Founders Fund

Founders

Tanay Tandon

Tanay Tandon

Founder & CEO

LinkedIn
EK

Eugene Kuznetsov

Founder & CTO

PC

Pavan Choksi

Co-Founder

What happens next.

No applications, no recruiter spam. Just the intro.

01

Confirm the fit

A few questions to make sure this role is the right shape for you. Two minutes.

02

I pitch you to the company

I write the intro, send it to the founder, and handle the back-and-forth.

03

A meeting lands on your calendar

If they’re a yes, I book the chat. You show up — that’s the whole job-hunt.