Staff Software Engineer, Accounts & Ledgering
- Location
- Mountain View
- Workplace
- Hybrid
- Compensation
- $210k – $275k + equity
About this role
What we're looking for:
We need a Staff Software Engineer with 8+ years of experience building backend systems and 3+ years designing and operating financial systems from 0-to-1. We're looking for someone who has built a double-entry payment ledger that has deep expertise in accounts and ledgering — payments, billing, reconciliation, ledgers, or accounting. You should be comfortable owning the full architecture of money-critical systems at scale and have a track record of designing immutable, event-oriented data models where correctness is non-negotiable. Bonus points if you have healthcare RCM, insurance remittance (835/ERA), or bank reconciliation experience.
What you'll do:
Design and operate a double-entry payment ledger and the next-generation account and ledger model — immutable events, derived balances, and clear semantics around payer balance vs. patient balance vs. adjustments vs. cash, with invariants that make it structurally impossible to "print money"
Take ownership of the full money path: insurance ledger, posting/adjustment engines, patient account ledgers, bank reconciliation, and reporting/AR
Reconcile multiple sources of truth — billed charges, payer remittances, bank deposits, and financial reports — and 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 with 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
Mentor Senior and Staff engineers, run architecture and design reviews, and push the technical bar higher through clear direction and honest feedback
Own complex, cross-system initiatives end to end: architecture, implementation, migration, rollout, and production operations
What happens next
Skip the application pile. I get you in front of the people who decide.
Confirm the fit
A few questions to make sure this role is the right shape for you. Two minutes.
I pitch you to the company
I write the intro, send it to the founder, and handle the back-and-forth.
A meeting lands on your calendar
When the company wants to meet, I get the call on your calendar. You just show up.
Culture & values
Mission to simplify healthcare and reimagine the healthcare experience
Bold ambitions to set a new standard for care delivery across the industry
Focus on enabling providers and administrators to concentrate on providing care
Vision to move from upstart innovator to industry standard
Commitment to tackling healthcare's most pressing challenges
Know someone who'd be great for this?


