USD per year
Company
Substrate Artificial Intelligence for your medical billing team Location: San Francisco, CA, US Salary: $140K - $200K + 0.01% - 0.10% equity Job type: Full-time Role: Engineering, Backend Experience: 3+ years Visa: US citizen/visa only
About Substrate
Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. The company focuses on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate accounts receivable (AR) and get reimbursed quickly and cost-effectively. They already process over 500k healthcare claims each month.
The Role
Position: Harness Engineer Responsibilities include building systems around AI agents and products to improve AI systems in production, increasing success rates for probabilistic products, and precision for deterministic ones. The engineer will build systems that understand complex healthcare contracts, read EDI companion guides, navigate sensitive healthcare and financial infrastructure, and make intelligent decisions about claims processing to help healthcare providers get paid fairly.
What You'll Work On
- Build and extend a suite of agents to perform tasks such as monitoring claims, reviewing payer policies, determining medical necessity, iterating through provider data, reconciling payments.
- Deploy agents safely in sensitive client environments.
- Develop high-quality measurement infrastructure to track agent/model behavior, improve precision, optimize speed and cost on production traffic handling tens of millions of claims yearly.
- Adapt to evolving work nature by exploring more effective and efficient workflows with evolving tools.
Candidate Fit
- Experience taking extreme ownership in previous roles.
- Deep problem-solving focus for excellence.
- Track record of independently building/shipping ML/AI products solving real business problems.
- Deep experience with modern LLM architectures, fine-tuning approaches, and large-scale evaluations.
- Healthcare domain knowledge or strong interest in automating healthcare processes using AI.
- Startup experience such as founding a company or early startup engineering roles.
- Proficient traditional software engineering skills plus adoption of coding agents in workflow.
- Willingness to work in person in San Francisco 3 days a week.
Compensation
Meaningful salary and equity available.
Interview Process
- Candidates must show something they have built (handmade or AI-generated), explain how it was built including prompts used, problem choice rationale, and results.
- Technical interview includes coding ability evaluation and an AI-assisted part demonstrating adoption of AI technologies in coding practice.
Additional Information About Substrate
Substrate builds browser-based AI agents for healthcare RCM aiming to augment/replace employees rather than software providers use. Target market is the $14 billion outpatient RCM market. The team has deep expertise in healthcare, AI & full-stack engineering with multiple startups experience and strong healthcare network.
Substrate AI provides AI Native Revenue Cycle Management (RCM) software that autonomously completes mission-critical tasks in healthcare revenue cycle such as claim status, appeals, policy reviews, payment posting, refunds, and more. Their agents connect to healthcare systems and run accounts receivable autonomously from claim status and appeals to payment posting and refunds. The software integrates with PM, EHR, and clearinghouse systems without migration and is live within 48 hours for most practices. It offers features like full audit trail, human-in-the-loop escalation for uncertain cases, predictive insights on payer trends and denial patterns, eligibility checks, payer policy review, document review automation, and tailored automation pipelines built by AI engineers embedded with client teams. The platform emphasizes security with end-to-end encryption, zero-trust architecture, periodic security audits, granular access controls, and compliance with HIPAA and SOC2.
View Company Profile