Substrate

About Substrate Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. We’re focused on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate AR, and get reimbursed quickly and cost effectively. We already touch over 500k healthcare claims each month.  The Role We're looking for an exceptional Harness Engineer to help build the systems around our agents and AI products. You'll be instrumental in advancing AI systems that are already in production, and improving success rates for probabilistic products, and precision for deterministic ones. You’ll build systems that can understand complex healthcare contracts, read EDI companion guides, utilize tools for navigating highly sensitive healthcare infrastructure and banking/financial infrastructure, and make intelligent decisions about claims processing - all in service of helping healthcare providers get paid fairly. What You'll Work On Build and extend our suite of agents - Design agents and the systems around them to do a variety of tasks for healthcare practices, including monitoring claims, reviewing payer policies, determine medical necessity, iterate through messy provider data, reconcile payments, and more. Deploy agents and the systems around them - Partner with clients and prospects on frontier use cases, getting agents to work safely in extremely sensitive environments. Develop high quality measurement infrastructure: improve how we measure and track agent and model behavior, increase precision, and build systems to help optimize speed, and cost on production traffic touching tens of millions of claims each year. Adapt with the nature of work: How work gets done is changing. Individuals have enormously more leverage than ever before. A big part of the role (and all roles at Substrate) is exploring how to be more effective, efficient and leveraged as the toolscape evolves rapidly around us. You Might Be a Fit If You’ve been load bearing in previous roles, and are willing to take an extreme amount of ownership. You are interested in going deeper into problems than anyone reasonable would, in service of excellence. You have a track record of independently building and shipping ML/AI products that solve real business problems Deep experience with modern LLM architectures, fine-tuning approaches, and utilizing evals at scale You either have healthcare domain knowledge already, or you’re excited about using AI to automate the tedium in healthcare You’ve either started a company before, launched and scaled independent products, or have been an early startup engineer You are both proficient as a software engineer in the traditional sense, and you've fully adopted coding agents into your workflow. You’re excited about working in person, in San Francisco, 3 days a week. Some general color on what we’re looking for: https://writing.kunle.app/p/come-work-with-me-at-substrate . We encourage you to apply even if you do not believe you meet every single qualification. Not all strong candidates will meet every single qualification as listed. If you spike extremely in certain areas or not in others, or if you’re extremely interested in this work and willing to go very deep to create something special, please apply and lets chat. Compensation Meaningful salary and equity available.

About Substrate Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. We’re focused on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate AR, and get reimbursed quickly and cost effectively. We already touch over 500k healthcare claims each month.  The Role We're looking for an exceptional AI Agent engineer to help build our autonomous agent platform and rebuild legacy healthcare workflows with AI Agents at the center. You'll be instrumental in developing AI systems that are already in production, that can understand complex healthcare contracts, read EDI companion guides, utilize tools for navigating highly sensitive healthcare infrastructure, and make intelligent decisions about claims processing - all while maintaining perfect memory of every interaction. What You'll Work On Build and extend the Claim Status Agent - Design intelligent sub-agent architectures that orchestrate multi-route claim lookups (EDI 276/277, payer portals, direct APIs, multiple clearinghouses). You’ll implement recovery strategies that adapt in real-time to payer errors. Develop self-enriching context systems - Create memory infra that lets our agents remember what works, which parameter combinations return actionable data, and how to route optimally across thousands of payers Fine-tune models and build evaluation frameworks - improve precision, speed and cost on  production traffic processing ~6m claims/year and growing. Design evals that catch regressions before clients do.  Expand the agent's capability surface - Integrate new modalities (voice, direct payer connections) and develop techniques for efficiently processing highly varied context across EDI companion guides, payer contracts, PDFs, images, and API outputs You Might Be a Fit If You have a track record of independently building and shipping ML/AI products that solve real business problems Deep experience with modern LLM architectures, fine-tuning approaches, and utilizing evals at scale You either have healthcare domain knowledge already, or you’re excited about using AI to automate the tedium in healthcare You’ve either started a company before, launched and scaled independent products, or have been an early startup engineer in a team smaller than 10 people You are both proficient as a software engineer in the traditional sense, and you've fully adopted coding agents into your workflow. You’re excited about working in person, in San Francisco. Some general color on what we’re looking for: https://writing.kunle.app/p/come-work-with-me-at-substrate . We encourage you to apply even if you do not believe you meet every single qualification. Not all strong candidates meet every single qualification. If you’re experiencing imposter syndrome and doubting the strength of your candidacy, please don’t exclude yourself prematurely. Slope often matters far more than intercept. If you spike extremely in certain areas or not in others, or if you’re extremely interested in this work and willing to go very deep to create something special, please apply and lets chat. Compensation Meaningful salary and equity available.

About Substrate Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. We’re focused on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate AR, and get reimbursed quickly and cost effectively. We already touch over 6m claims/yr. The Role We're looking for an exceptional Forward Deployed Engineer to help large healthcare organizations safely and productively deploy AI within mission critical RCM workflows including AR Follow up, Payment Reconciliation, Lockbox Automation, Collections Management, Appeals management, and more. You'll be instrumental in ensuring high quality deployments are delivered on time, measured well, coordinated with change management, and continuously optimized and improved as we scale. What You'll Work On Problem Definition & Solution Design: deeply understanding A client's needs and articulating them in a way that our team can clearly understand and rethinking clients' workflows from first principles in an AI-native way. Productize Onboarding & Implementation: Create onboarding and implementation workflows and playbooks that enable us to onboard many, many more enterprise-scale clients in parallel at once with a results orientation. Manage Deployments and Support Operations: scalably deploy agents in mission critical environments with extremely sensitive data, alongside a small dedicated team.  Build Trust: Act as a trusted advisor to healthcare organizations navigating the rapidly changing AI landscape.   You Might Be a Fit If You have a track record of independently building and shipping ML/AI products that solve real business problems Deep experience with modern LLM architectures, fine-tuning approaches, and utilizing evals at scale You either have healthcare domain knowledge already, or you’re excited about using AI to automate the tedium in healthcare Excellent communication skills and experience working directly with enterprise customers, in a front facing role Ability lead cross-functional engineering efforts and deliver production systems You’re excited about working in person, in San Francisco. Some general color on what we’re looking for: https://writing.kunle.app/p/come-work-with-me-at-substrate . We encourage you to apply even if you do not believe you meet every single qualification. Not all strong candidates meet every single qualification. If you’re experiencing imposter syndrome and doubting the strength of your candidacy, please don’t exclude yourself prematurely. Slope often matters far more than intercept. If you spike extremely in certain areas or not in others, or if you’re extremely interested in this work and willing to go very deep to create something special, please apply and lets chat. Compensation Meaningful salary and equity available. We’re building a small, tight knit team whose motivated to win together.

About Substrate Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. We’re focused on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate AR, and get reimbursed quickly and cost effectively. We already touch over 500k healthcare claims each month.  The Role We're looking for an Technical Success Manager to to make client experiences magical. This involves deeply understanding client needs, leaders, and processes, our interfaces with client systems, and the underlying stack used to support them. You’ll help clients run down problems and help engineers explore new opportunities with clients, and you’ll help clients understand how agents are working in production, and understand their data. This is a role for someone who finds vague answers unsatisfying, and derives deep pleasure from enabling clients to be more successful. What You'll Work On Own the Client Relationship: Primary point of contact for clients from pilot through expansion. Build trust with operators and executives by showing up with answers, not ticket numbers. Investigate and Diagnose: Take customer-reported anomalies all the way to root cause, without waiting for an engineer to guide you. Query production databases, trace through the codebase, and reconstruct exactly what happened. Develop autonomous tools: Create new, differentiated tools for understanding production problems more quickly and reliably, and scaling client interactions. Prototype and Demo: Show customers what better looks like before engineering builds it. Turn unarticulated client needs into high fidelity use cases for us to explore You Might Be a Fit If You’ve been load bearing in previous roles, and are willing to take an extreme amount of ownership. You are interested in going technically deeper into problems than anyone reasonable would, in service of excellence. You’re comfortable in code, SQL and data You have owned customer relationships in a B2B SaaS or Enterprise software or agentic AI environment with real accountability for retention or expansion Deep experience with modern LLM architectures, fine-tuning approaches, and utilizing evals at scale You either have healthcare domain knowledge already, or you’re excited about using AI to automate the tedium in healthcare High agency: when blocked you find another path; when uncertain, you investigate rather than waits You’re excited about working in person, in San Francisco, 3 days a week. Some general color on what we’re looking for: https://writing.kunle.app/p/come-work-with-me-at-substrate . We encourage you to apply even if you do not believe you meet every single qualification. Not all strong candidates will meet every single qualification as listed. If you spike extremely in certain areas or not in others, or if you’re extremely interested in this work and willing to go very deep to create something special, please apply and lets chat. Compensation Meaningful salary and equity available.