The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“Strong backend engineering (Python preferred) and deep experience with relational databases at scale: query performance, ACID transactions, safe migrations, data integrity”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“File-based integrations, bank reconciliation, event-sourced/CDC architectures, or high-throughput batch pipelines”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“File-based integrations, bank reconciliation, event-sourced/CDC architectures, or high-throughput batch pipelines”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“You’ve shipped production systems with observability, alerting, and incident response practices, especially for high-stakes workflows”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“You’ve shipped production systems with observability, alerting, and incident response practices, especially for high-stakes workflows”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“Strong backend engineering (Python preferred) and deep experience with relational databases at scale: query performance, ACID transactions, safe migrations, data integrity”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
The ad says“Strong backend engineering (Python preferred) and deep experience with relational databases at scale: query performance, ACID transactions, safe migrations, data integrity”
The ad says“Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history”
We’re hiring a Staff Software Engineer to own the accounts and ledgering spine of our RCM platform
This is the path from “insurance paid us” to “the books balance, the patient knows what they owe, and leadership can trust the numbers.”
The team is designing and building the next generation of our account and ledgering system. We’re moving toward an event-oriented financial model where every charge, payment, adjustment, and refund is immutable
Balances get derived from history rather than maintained by hand. Reporting should fall out of the design, not be stitched together afterward
Your team owns the full money path:
The insurance ledger append-only entries recording payer payments, contractual adjustments, denials, and patient responsibility buckets per procedure, with reversal/refund chains for corrections
Posting and adjustment engines that turn remittances into ledger entries and automatically write off, rebucket, or transfer amounts to patient responsibility based on customer rules
Patient account ledgers tracking balance, payments, credits, and refunds that drive statements, the patient portal, and collections
Bank reconciliation — matching insurer checks to actual bank deposits (via bank APIs, BAI2 files, OCR’d deposit slips) so we only post against verified dollars
Reporting ledger and AR — procedure-level rollups, point-in-time views, AR aging, collections reports, plus drift detection when operational balances disagree with reports
An emerging unified event stream that will become the backbone of a cleaner, replayable ledger architecture
Design the next-generation account and ledger model, immutable events, derived balances, clear semantics around payer balance vs. patient balance vs. adjustments vs. cash, with invariants that make it structurally impossible to “print money”
Keep operational balances and financial reports in lockstep. Posting, adjustments, patient balances, rollups, and balance reports need to agree. When they don’t, we need drift detection and self-healing
Reconcile three (or four) sources of truth: billed charges, payer remittances, bank deposits, and financial reports. 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, 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) and make sure the team actually lives by it
Work hand-in-hand with platform and product teams to keep sensitive customer data protected, tighten security boundaries, and stay on top of our regulatory and compliance obligations
Own complex, cross-system initiatives end to end: architecture and design, implementation, migration, rollout, and everything that comes with running it in production
Make pragmatic calls that weigh security, correctness, reliability, performance, and simplicity against how fast we need to ship
Mentor Senior and Staff engineers, run architecture and design reviews, and push the technical bar higher through clear direction, strong engineering habits, and honest feedback
Take real ownership in a fast-moving environment. Spot systemic risks early and fix the root cause instead of patching around it
Preferred experience
Strong backend engineering (Python preferred) and deep experience with relational databases at scale: query performance, ACID transactions, safe migrations, data integrity
You’ve shipped production systems with observability, alerting, and incident response practices, especially for high-stakes workflows
Real experience designing or operating financial systems, payments, billing, reconciliation, accounting, or ledgers. You get double-entry accounting, append-only ledgers, idempotency, reversals, and why balances need to be derived from immutable history
Strong communication and collaboration skills. You can work with ops and customers when correctness matters
8+ years building software, with a track record of Staff-level work, architecture ownership, mentoring, cross-team influence
Healthcare RCM, patient accounting, insurance remittance (835/ERA), AR aging, or practice-management billing
Experience evolving a monolith toward clearer domain boundaries or event-oriented model
File-based integrations, bank reconciliation, event-sourced/CDC architectures, or high-throughput batch pipelines
