Senior Engineering Manager, Payments & Reconciliation

At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs. Healthcare carries a $1 trillion administrative burden and we're at the center of transforming it. Today, 500,000+ clinicians across 500+ healthcare organizations nationwide trust Commure to handle $25B+ in annual claims and support over 200 million patient interactions. Our latest $70M raise at a $7B valuation reflects the confidence the market has placed in this mission. We've also been named to the Fortune Future 50 list and the 2026 AI Breakthrough Awards for “Overall NLP Company of the Year.” Our team works directly alongside clinicians, not through layers of process, which means the gap between what you build and its impact on patient care is immediate. We move fast, deploy daily, and take full ownership from early thinking to production. If you're energized by hard problems, high stakes, and a team that holds itself to a high bar, you'll find your people here. The future of healthcare is being built right now. Come deliver this transformation. About the role The Revenue Cycle Management team is hiring for a Senior Engineering Manager to join the team. We build software that helps medical practices get paid accurately. This role leads the engineering team that owns the money-in path: everything from when an insurer says how much they'll pay, to when that payment is on the books, verified against the bank, and the patient knows what they still owe. You will manage a team of ~6 engineers across the full payments surface, reading insurer payment files, matching them to the right claims, recording money on visits, reconciling with bank deposits, calculating patient balances and collections, and partnering with the team that builds the financial reports clinics rely on. A near-term priority is to hire 2 engineers to strengthen the team. You are the people leader and delivery owner: hiring, coaching, planning, and shipping outcomes, while staying close enough to the systems to set technical direction and unblock hard problems. Together with teams that submit claims, handle denials, and build financial reporting, this group covers the path from "insurance paid us" to "the books are right, the patient knows what they owe, and leadership can trust the numbers." What the Team Builds Reading insurer payment files Insurers send payment detail files (and paper explanations of benefits) through many networks and formats. The team ingests those files, turns them into structured payment records, and keeps each claim's status up to date as money comes in. This is the start of the pipeline — everything downstream depends on it being correct. Matching payments to the right claims Each payment line has to be linked back to the claim we originally submitted. Payers often send incomplete or inconsistent identifiers, so we use scoring across many signals (patient info, policy numbers, providers, amounts) and test changes on historical data before they affect real money. Recording payments on the books Once matched, payments are recorded on the correct visit using per-clinic rules — what to write off, what to shift to the patient, how contractual rates apply. Corrections use safe reverse-and-repost flows so history stays auditable. The books have to balance; "close enough" is not good enough. Matching payments to the bank For many customers, we verify that insurer checks actually landed in the clinic's bank account — using live bank connections, standard bank files, and scanned deposit slips. Until the deposit is verified, automatic recording of payments can be held. This includes the messy long tail of check numbers and payer names that don't match cleanly. Patient balances and collections After insurance pays, we calculate what the patient still owes and feed statements, the patient payment experience, credits, refunds, and collections. Balance logic has to keep up whenever posting or clinic rules change. Financial reports clinics trust The payment and ledger work this team owns feeds the reports and dashboards clinics use to run the business. You will partner closely with our financial reporting team so that billing, recorded payments, patient balances, and reports stay in agreement — catching drift early rather than after a customer notices it. Scale: Large volumes of visits and payment lines, background jobs and scheduled pipelines, rule engines with hundreds of clinic-specific conditions, and zero tolerance for balances that don't add up. What You'll Do People & team leadership Manage a team of ~6 engineers across payment file processing, matching, ledger recording, bank reconciliation, patient balances/collections, and integration with financial reporting. Hire 2 engineers as an immediate priority; then continue to coach, retain, and grow the team through performance reviews, career development, and a healthy on-call culture. Balance shipping new work vs. keeping money systems reliable — roadmap delivery without burning people out or risking incorrect balances. Grow senior engineers who can deeply own areas (matching, posting, bank recon, patient billing) while the team still operates as one unit. Technical & product leadership Set direction for the full path: payment file to match to claim to record on books to adjust to verify in bank to patient balance to reports — where to invest for accuracy, reliability, and trust. Align with neighboring teams (claims submission, denials, financial reporting, patient product, and operations) so handoffs are clear and problems are caught early. Invest in visibility and operability: the ability to follow a payment from the insurer's file all the way to a patient balance and a report row — with dashboards and runbooks that work when something breaks overnight. Guide careful changes to large databases and long-running jobs, with clear rollout and rollback plans. Execution & planning Own quarterly planning and goals; break large initiatives into small, shippable steps (better matching, higher bank match rates, faster/safer recording, fewer patient-balance surprises, clearer reporting handoffs). Represent the team with product, operations, and leadership; communicate tradeoffs clearly. Reduce repetitive support work: push clinic configuration toward self-service tools instead of one-off engineering changes. Our Tech Stack Backend: Python (FastAPI) Database: PostgreSQL Caching: Redis Async processing: Background jobs, task queues, and schedulers for batch payment processing Cloud: Major public cloud provider Monitoring: Prometheus + Grafana Frontend: React (and some Vue), plus reporting product surfaces Collaboration: Notion, Linear What You Have Required 3+ years managing software engineers (hiring, performance, career growth), with experience leading a team of roughly 5-8+ engineers on backend-heavy systems Track record shipping and operating financial, payments, billing, reconciliation, accounting, or collections systems in production — you understand why money systems can't be "eventually correct." Strong enough technical judgment on large databases, background pipelines, and complex business rules to challenge designs, prioritize investment, and unblock escalations — without needing to write every line of code. Experience partnering with operations or customer-facing teams when correctness and clear explanations matter. Clear written and verbal communication; comfort owning incidents and summarizing them for stakeholders. Strongly preferred Healthcare billing, insurance payments, patient accounting, bank reconciliation, or practice-management background — or deep fintech / accounting-platform