Founding AI Engineer

Location: New York City, NY (Union Square)
Company Stage of Funding: Early-Stage, Venture-Backed AI Startup
Office Type: Hybrid (3 Days Per Week)
Salary: $120,000–$150,000 + Meaningful Early-Stage Equity

Company Description

We're representing an early-stage AI company building intelligent agents to automate non-clinical healthcare workflows. Their mission is to help healthcare providers get paid faster by accurately understanding what happened during patient visits and dramatically shortening the revenue cycle.

Already working with clinics, hospitals, and health centers and generating six figures in ARR, the company is now investing in the foundation of its AI and machine learning platform. The team is productionizing systems built on frontier models, developing RAG infrastructure over complex healthcare data, and moving into real-world LLM fine-tuning for medical coding workflows.

This is an opportunity to join a small, highly technical team at an early stage and work directly with the founders on AI systems trained and evaluated against real, high-value healthcare datasets.

What You Will Do

• Design, build, and productionize AI systems powering medical coding and healthcare revenue workflows.
• Build RAG pipelines across clinical notes, billing data, coding guidelines, and other complex healthcare datasets.
• Develop chunking, hybrid search, retrieval, and guardrail strategies designed for accuracy and auditability.
• Adapt and fine-tune LLMs using techniques such as LoRA, QLoRA, PEFT, and instruction tuning.
• Develop model workflows for ICD-10, CPT, and HCPCS code suggestions and explanation generation.
• Build evaluation infrastructure to measure model accuracy, investigate failures, compare model versions, and accelerate experimentation.
• Productionize model and prompt infrastructure built on top of leading frontier models.
• Build and maintain AI infrastructure on GCP.
• Own data ingestion pipelines, background jobs, monitoring, and integrations with healthcare systems.
• Develop integrations with EHR and revenue cycle management platforms, including VLM/computer-use approaches for legacy systems.
• Work with messy, real-world data including PDFs, exports, clinical records, and inconsistent structured datasets.
• Partner directly with the founding team to make pragmatic technical decisions and rapidly move systems from experimentation into production.

Ideal Candidate Background

• Strong software engineering fundamentals with hands-on experience building LLM-powered systems, ideally in production.
• Strong proficiency in Python, TypeScript/Node.js, Go, Rust, or another production-grade programming language.
• Experience building RAG, retrieval, LLM application, or AI infrastructure systems.
• Comfortable working across experimentation and production engineering rather than focusing exclusively on model research.
• Experience designing evaluation loops and systematically measuring AI system performance.
• Ability to work effectively with messy, unstructured, and imperfect real-world datasets.
• Experience using AI coding agents such as Codex or Claude Code, with a thoughtful perspective on how to incorporate them into engineering workflows.
• Strong ownership mindset with the ability to make pragmatic technical tradeoffs and ship quickly.
• Comfortable operating in an ambiguous, early-stage startup environment.
• Based in New York City and able to work from the Union Square office three days per week.

Preferred

• Experience fine-tuning LLMs using LoRA, QLoRA, PEFT, instruction tuning, or similar techniques.
• Healthcare, healthtech, EHR, or revenue cycle management experience.
• Familiarity with medical coding systems including ICD-10, CPT, or HCPCS.
• Experience with clinical NLP or AI systems operating on medical data.
• Experience handling PHI and building systems within HIPAA-regulated environments.
• Familiarity with healthcare interoperability standards such as HL7, FHIR, X12/837, or X12/835.
• Experience building integrations with EHR or RCM platforms.
• Familiarity with vision-language models or computer-use agents for interacting with legacy software.
• Experience deploying and operating AI workloads on GCP.
• Interest in strongly typed programming languages such as Haskell or Elm.
• Genuine interest in applying AI to difficult, high-impact healthcare problems.

Compensation and Benefits and Other Things

• Base salary: $120,000–$150,000.
• Meaningful early-stage equity.
• Health, dental, and vision insurance.
• Hybrid schedule with three days per week in the Union Square office in New York City, with occasional periods of more frequent in-person collaboration.
• Direct access to and collaboration with the founding team.
• Opportunity to build foundational AI infrastructure using real healthcare datasets and take systems from experimentation and fine-tuning through production deployment.
• High-ownership environment where you'll have meaningful influence over the company's AI architecture, engineering practices, and technical direction.