About the role
Founding Engineer — Overdrive Health (YC W26)
New York City (In-Person) · Full-Time
About Overdrive Health
Medical billing is a $150B+ industry still run almost entirely by people doing manual administrative work: logging into payer portals, looking up codes, writing appeals, making phone calls. There are over 7,000 billing companies in the US, and 80% of their costs are human labor that AI can now automate.
Rather than selling software to an industry that's slow to adopt it, we acquire billing companies and deploy AI directly into their operations. We automate insurance phone calls, document processing, benefit verification, claim coding, denial management, and more. We capture 100% of the value we create, and every acquisition expands our client base, our data, and our ability to automate.
We started in ambulance billing ($2B market). Our first billing company serves 25 ambulance agencies and is on pace to collect $60M this year. In four months, we've increased revenue per employee by 1.7x and eliminated 75% of the offshore team through automation. We have a ton left to build just to get this first billing company to a true AI-native business, and then we'll expand into other verticals.
The Founder
Overdrive is led by Michael Schroeder, who led core AI engineering at EliseAI (scaled from $35M to $115M ARR; $250M Series E led by a16z) and led engineering at Up&Up, a full-stack property manager ($30M Series B from Khosla and Founders Fund). Before that: Citadel, Meta, Duke CS.
The Role
You'd be the first engineering hire, working directly with Michael to build and expand the AI systems that power our billing operations. This is not a research role. Our agents are already in production handling real claims and real money. You'll be shipping code that has a direct, measurable impact on revenue from day one.
The work is varied. One week you're building an AI agent that navigates a payer's phone tree to verify benefits. The next you're designing the data pipeline that routes thousands of claims through the right automation workflows. Then you're building an internal tool so our billing team can review agent outputs and flag edge cases. You should be the kind of engineer who's more excited about solving a gnarly integration problem with a payer API than picking a frontend framework.
