An early-stage, YC-backed company at the intersection of AI and healthcare operations is hiring its first engineer. You will work directly with the founder - a repeat operator who has scaled AI systems from seed to $100M+ ARR - to build and expand the AI platform powering a real, revenue-generating business.
About the company
The company operates in a $100B+ industry where the majority of work is still done manually by people navigating portals, writing appeals, and making phone calls. Rather than selling software to a slow-moving market, this company acquires businesses in the sector and deploys AI directly into their operations - capturing the full value of every automation it ships.
AI agents are already in production. The business is on pace to process $60M in revenue this year. In four months, automation has increased revenue per employee by 1.7x and eliminated 75% of the offshore team. There is a large amount left to build, and this role exists to accelerate that.
The role
This is a hands-on founding engineering role with significant architectural responsibility. You will not be handed a spec. One week you may be building an AI agent that navigates a phone tree to verify insurance benefits. The next, you may be designing a data pipeline that routes thousands of claims through the right automation workflows, or building internal tooling that closes the feedback loop between human operators and AI agents.
You will make foundational architecture decisions, shape the product roadmap based on what you see in the data, and help build the engineering team and culture from scratch.
What you will do
- Build and iterate on AI agents automating core workflows - insurance phone calls, claim follow-ups, denial appeals, benefit verification, and document extraction
- Design and maintain backend systems, data pipelines, and integrations with healthcare and insurance infrastructure including payer portals, clearinghouses, and clinical record systems
- Make foundational architectural decisions that will scale as the company expands into new verticals
- Build internal tooling so the operations team can review agent outputs, flag edge cases, and feed improvements back into the system
- Work directly with the operations team to identify where automation creates the most leverage, then ship quickly
Tech stack
Python-heavy backend, AI/LLM agent frameworks, workflow automation, integration with external APIs and telephony systems
About you
- Strong backend engineering fundamentals - comfortable designing systems, writing reliable production code, and debugging complex problems across the stack
- Experience building with LLMs or AI agents in production, not just in prototypes
- High agency - you are used to deciding what to build, not just how to build it, and taking full ownership over your projects without needing detailed specs
- Strong bias toward shipping; you care more about solving the problem than perfecting the abstraction
- Python proficiency
Bonus
- Experience in healthcare, insurance, or other heavily regulated industries
- Background with telephony systems (e.g. Twilio, SIP), document processing, or workflow automation
- Previous early-stage startup experience
Join a small, high-calibre founding team with real traction, real revenue, and a massive market ahead. This role offers genuine ownership, foundational architectural influence, and the opportunity to shape how AI is deployed in a critical, complex industry - from day one.
