About the client:

Location: New York City (Hybrid; some weeks may require up to 5 days/week in-office, other weeks only 1 days but we average 3 days a week)

We’re an early-stage, venture-backed startup building AI systems for medical coding and revenue cycle workflows. We’re looking for a Founding AI Engineer to take end-to-end ownership of core AI systems—from data ingestion and retrieval to model adaptation and production deployment.

This is a hands-on role in a fast-paced environment with high responsibility and meaningful equity upside.

What You’ll Work On

• Design and build RAG systems over clinical notes, billing data, and coding guidelines

• Adapt and fine-tune LLMs (LoRA/QLoRA, instruction tuning) for medical coding and explanations

• Help architect and operate GCP-based infrastructure (Cloud Run/GKE, Vertex AI, BigQuery, Pub/Sub)

• Build evaluation and feedback loops to measure accuracy and quality

• Own integrations with EHRs, RCM systems, and other healthcare data sources

What We’re Looking For

• Experience building and shipping LLM + RAG systems in production

• Hands-on experience with model adaptation or fine-tuning techniques

• Strong backend engineering skills (Python, TypeScript, or similar)

• Comfortable working with messy, real-world data and production systems

• Ownership mindset and ability to move quickly in an early-stage startup

Nice to Have

• Healthcare, EHR, or medical coding experience (ICD-10, CPT, HCPCS)

• Experience handling PHI and working in HIPAA-regulated environments

• Familiarity with Vertex AI or high-performance inference

• NYC-based or able to be in-office periodically

Compensation

• Base Salary: $120,000 – $150,000

• Equity: Meaningful early-stage equity