Founding Backend Engineer (Senior/Staff)

Remote (US)

Full-time

$150,000–$225,000 with equity

Fonzi is partnering with our client to hire a Founding Backend Engineer. Only candidates located in the United States will be considered for this role.

Mission

Our client is the all-in-one service to save time, money, and stress on health insurance and medical bills.

Medical bills are a massive problem. They are confusing, over 40% contain errors, 17% of claims are denied by insurance, and often represent very large sums of money. As a result, 100 million Americans are saddled with medical debt, and medical bills cause nearly 70% of personal bankruptcies in the US.

Dealing with unexpectedly high medical bills is time-consuming, complex, and stressful. Stuck between providers, payers, and bill collectors, consumers frequently have to make numerous phone calls, wait on hold, and even send paper letters and faxes. Appealing insurance denials, resolving billing errors, negotiating bills, and filing out-of-network claims require expert knowledge that most consumers don't have.

Thanks to AI and new healthcare regulations around data access and price transparency, our client can now automate this soul-crushing work and empower consumers to fight back against this broken system. Beyond medical bills, they help people through their entire healthcare journey as they pick their health insurance plans and benefits, or look for care that fits their budget.

Team

Our client is founded by 2 Oscar Health veterans, the first health insurance company built around a full stack technology platform and a relentless focus on serving its members. They joined Oscar pre-product, stayed through the IPO and helped it grow to over 1M members. They've worked across Oscar's entire stack and led many key projects, including its in-house telemedicine platform and claim system.

They're proud of how Oscar raised the bar for what people should expect from their health insurance, and they're excited to have an even larger impact by taking the side of consumers unequivocally, regardless of their health insurance.

They're lucky to be backed by the founders and investors at Hugging Face, Oscar Health, TrueBill, CaseText, Forerunner Ventures, Red Sea Ventures, RRE Ventures, and much more. Our client is well-funded for the next few years.

Technology

At a high level, our client's assistant analyzes medical bills, identifies potential issues such as errors or undue denials, and helps resolve them. It sends emails, faxes, and letters and acts as a voice co-pilot during phone calls with relevant stakeholders. Additionally, their assistant can accomplish various admin tasks on the web on users' behalf.

A lot needs to happen under the hood to make all of this possible:

• We must fetch, process, and analyze billing and clinical information from various sources
• We must interact with humans across multiple mediums (voice, text, documents) and platforms (web, iOS, Android, phone, faxes)
• We must define and orchestrate many multi-step processes driven by LLM agents in cooperation with rich human-in-the-loop interactions
• We need to make real-time recommendations and predictions using complex decision trees maintained in partnership with our clinical and legal teams
• And more!

Our client has made key foundational technology choices to keep the team hyper-productive:

• A monorepo with TypeScript for everything (mobile + web, back-end, infrastructure as code, build tools) to make it easy to contribute across the stack and write type-safe and highly concurrent code
• Supercharged TS with Effect for orchestrating highly concurrent and complex parts of the stack
• EdgeDB is used as the main transactional database. It includes a highly modern and productive toolset, including a type-safe ORM, builtin GraphQL server, ACLs, branching and migrations, etc.
• A unified data GraphQL server that aggregates all the data sources seamlessly, making it trivial to query and update data across the stack through a single API
• All infrastructure is managed with Docker and Pulumi and deployed on AWS to keep everything secure and auditable
• All asynchronous and long-running jobs are orchestrated with Temporal, simplifying distributed workload execution
• And more!

About the role

• Be a founding member of this growing team! Help to shape the future success and direction of the company
• Define and execute the roadmap with the CEO and the rest of the tech team as our client develops a private beta for official launch later this year
• Own exciting technical projects from beginning to end—through system design, full-stack programming, and feature launches

About you

• Have engineered software for 5 years or more
• Have at least 1 year in a hands on technical leadership role such as Tech Lead, Staff or Principal Engineer
• Are excited to be part of the mission!
• Thrive in a fast-paced environment, navigating ambiguity with a high degree of autonomy
• See the bigger picture, and design pragmatic solutions to the most pressing problems
• Approach cutting-edge technical challenges with curiosity, tenacity, and creativity
• Have strong communication skills, both written and verbal
• Have 10+ years of GPT4 experience—or, failing that, a sense of humor

Bonus: Experience working with healthcare data, complex integrations, web crawling, or AI-powered workflows.

These are ideal qualifications, not minimums. If you don't meet some, you should still apply!

Benefits

Our client offers:

• A competitive salary
• Meaningful equity - the goal is for every team member to benefit from the success!
• Top-tier medical, vision, and dental insurance
• One Medical membership
• Mental health benefits through Talkspace
• Unlimited PTO