Machine Learning Engineer

Recruiting From Scratch • San Francisco, NY

11h • $120,000 - $150,000 • Hybrid

About The Position

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.

Requirements

• 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 Haves

• 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

Responsibilities

• 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 This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed