Staff Software Engineer, Accounts & Ledgering Company: Confidential — venture-backed technology company Location: Hybrid in Mountain View, San Francisco, Los Angeles or New York City Compensation: $210,000 - $275,000 + competitive equity Employment Type: Full-time Visa Sponsorship: Visa transfers (OPT, H-1B transfer) About the Company The client's mission is to simplify healthcare. Its growing suite of AI solutions spans ambient clinical documentation, provider copilots, autonomous coding, revenue cycle management and more, so providers and administrators can focus on care. The client powers over 500,000 clinicians in a $4.5 trillion industry that spends more than $500 billion a year on administration. The client is a later-stage (Series D+) company that has raised $800M+. The Role The client is hiring a Staff Software Engineer (8+ years backend, 3+ years building financial systems from 0 to 1) who has built a double-entry payment ledger and has deep expertise in accounts and ledgering: payments, billing, reconciliation, ledgers or accounting. You will own the full architecture of money-critical systems at scale, with immutable, event-oriented data models where correctness is non-negotiable. What You Will Do • Design and operate a double-entry payment ledger and the next-generation account and ledger model, with invariants that make it structurally impossible to "print money". • Own the full money path: insurance ledger, posting and adjustment engines, patient account ledgers, bank reconciliation and AR reporting. • Reconcile billed charges, payer remittances, bank deposits and financial reports, and surface discrepancies before customers do. • Scale idempotent, explainable posting pipelines using negation/reversal semantics. • Operate money-critical systems on very large Postgres tables with safe migrations, projections, backfills and incident response. • Set the bar for observability and operational readiness, and mentor senior and staff engineers. What You Bring • 8+ years building backend systems, including 3+ years designing and operating financial systems from 0 to 1 • Hands-on experience building a double-entry payment ledger • Deep expertise in payments, billing, reconciliation, ledgers or accounting • Immutable, event-oriented data modeling where correctness is non-negotiable • Strong Python, PostgreSQL and SQL Nice to Have • Healthcare revenue cycle, insurance remittance (835/ERA) or bank reconciliation experience Tech Stack Python, PostgreSQL, event-driven architecture, SQL, REST APIs, distributed tracing, CDC, bank APIs, BAI2, OCR Before you apply: get a free recruiter-readiness score for your resume at CareerStanding — about a minute, no signup, and your resume stays in your browser.