Backend Engineer

• Establish and maintain active monitoring of ANSI X12 277CA claim acknowledgment transactions to confirm payers have received submitted claims
• Implement a tracking and escalation process for claims that have not received 277CA acknowledgment within defined payer-specific windows
• Partner with the Front End Revenue Cycle Manager and Engineering to ensure clean claim submission and minimize rejection rates at the clearinghouse level
• Maintain working knowledge of clearinghouse workflows and claim status tracking capabilities
• Own the Athena Health AR aging report — ensuring it accurately reflects payment status and is actively worked on a defined cadence
• Establish AR follow-up workflows by payer and aging bucket, with defined SLAs and escalation paths for each tier
• Drive systematic reduction of the over-180-day AR balance through targeted payer follow-up, appeals, and collections activity
• Coordinate with Finance and the Manager/Director of Operational Effectiveness to ensure AR balances in Athena are accurately reflected in Zuora and NetSuite through a defined reconciliation process
• Identify and escalate AR balances where the insurance collection path has been exhausted and the employer guarantee of payment clause may apply
• Build and manage a structured denial work queue in Athena Health with assigned ownership, defined SLAs, and a clear resubmission process for each denial reason code
• Analyze denial trends by payer, reason code, and service line to identify root causes and implement upstream controls to prevent recurrence
• Prioritize denial resolution based on dollar value and timely filing window expiration — ensuring high-value, near-deadline denials are worked first
• Establish appeals workflows for payer-specific appeal processes, including supporting documentation requirements and submission timelines
• Monitor denial overturn rates by payer and reason code, and use outcomes data to refine appeal strategies
• Partner with the Front End Revenue Cycle Manager to address eligibility-driven denials at the root — denials reflecting coverage terminations that should have been caught upstream
• Manage the collections process for both claims-billed payer populations
• Establish payer-specific follow-up protocols including call queues, correspondence templates, and escalation timelines
• Coordinate with Client Success on employer group collections, including communication protocols and escalation to the employer guarantee of payment process when appropriate
• Monitor and report on cash collection rates by payer against contracted PMPM rates, identifying and investigating variances
• Recruit, onboard, and develop back-end RCM staff including AR follow-up specialists, denial management analysts, and collectors
• Establish competency requirements, training programs, and performance expectations for all back-end positions — with particular emphasis on experienced denial management and collections hires
• Conduct regular AR review sessions with staff to ensure accounts are being worked effectively and escalations are appropriate
• Build a culture of accountability, data-driven decision making, and continuous improvement within the back-end team

Senior Manager, Back End Revenue Cycle

• Own meaningful parts of the backend
• Scope, design, ship, and stabilize the services the rest of the product depends on. Own the fix when something misbehaves at 2am.
• Make the architectural calls — data model evolution, caching boundaries, where to spend latency budget, when to refactor and when to rewrite.
• Work fluidly across the data layer. Relational stores at scale (MySQL, MariaDB) and document stores (Firestore) are both in the toolkit, and you know which to reach for and when.
• Treat infrastructure as code as part of the job. Terraform and Ansible aren’t someone else’s problem; a service isn’t shipped until it can be re-deployed without you in the room.
• Treat performance, observability, and operational health as part of “done.” Dashboards and alerts ship with the feature.
• Move across the stack when the work demands it
• Open TypeScript PRs in the Electron app when a feature is better wired end-to-end than handed off. You’re comfortable on both sides of the boundary.
• Have opinions on UX workflows and product surfaces, not just API shapes. The best backend engineers we’ve worked with care how the thing feels.
• Get into the Electron app, the overlay, or the web surface when that’s where the bug actually is.
• Drive the backend roadmap
• Take ownership of what we work on, what we cut, and what we sequence. The Head of Engineering will partner closely early on; the bar is that this person eventually drives the roadmap on their own.
• Push cross-cutting initiatives nobody else will — observability gaps, data model debt, perf regressions, API hygiene. The work that quietly compounds.
• Provide substantive code review, mentor where it lands naturally, and raise the level of design discussions when the design needs it, not just the implementation.
• Bring thoughtfulness and genuine passion for the work. Contribute to roadmap decisions with an eye on outcomes.

Senior Backend Engineer

• Lead the planning and execution of the migration from self-managed SQL Server on EC2 to AWS RDS (SQL Server)
• Drive database cost optimization: right-sizing instances, evaluating reserved Instances, storage tiering, and eliminating unnecessary licensing costs
• Upskill and mentor the existing Hospice SQL DBA team on AWS database operations, RDS management, and cloud best practices
• Establish cloud-native database monitoring, alerting, and performance baselines using Datadog and CloudWatch
• Design and implement automated backup, restore, and disaster recovery processes using AWS Backup
• Perform query optimization, index management, and capacity planning
• Collaborate with the DevOps team on infrastructure automation (Terraform for RDS)
• Ensure HITRUST E1 compliance for all database systems (encryption, access controls, audit logging)
• Support the Hospice application team with database-related development needs
• Evaluate future database modernization opportunities (PostgreSQL, Aurora) for the 2027 roadmap

Senior Database Engineer

• Lead the design and implementation of scalable data platforms and pipelines using PySpark, Spark, and Python
• Drive adoption and best practices for Palantir Foundry (data pipelines, ontology, workflows, and operational applications)
• Architect and optimize high-performance data processing solutions for large-scale datasets
• Provide technical leadership and mentorship to data engineers, ensuring code quality and best practices
• Collaborate with cross-functional teams (business, analytics, data science) to translate requirements into scalable solutions
• Design robust data models, ETL/ELT frameworks, and data integration strategies
• Ensure data quality, governance, security, and compliance across enterprise data platforms
• Lead performance tuning, troubleshooting, and optimization of data pipelines
• Drive CI/CD implementation, code reviews, and release management
• Stay current with emerging data engineering technologies and recommend improvements

See all jobs on JobTailor

Senior Manager, Back End Revenue Cycle

Senior Backend Engineer

Senior Database Engineer

Data Engineer, Palantir, Spark, PySpark, Python