Senior Product Engineer, RCM Operations

Duet is proving that nurse-practitioner-led care isn't just more accessible, it's better. We help NPs build and scale independent practices in communities too often overlooked by the health system: rural towns, immigrant populations, LGBTQ+ patients, and more. Backed by AI-driven tools that give independent NPs the backing of a much bigger system, our network of 100+ practices covering 400,000 annual visits has driven a 30% increase in preventative visits and a 35% drop in hospitalizations, the clearest sign yet that localized NP-led care means better outcomes.

We're a well-funded, early-stage company led by seasoned entrepreneurs and nurse practitioners, and backed by investors including Lerer Hippeau and Kairos.

Independent primary care is disappearing, swallowed by hospital systems and private equity roll-ups, often pulling out of the communities that need it most. But 31 states now support autonomous NP practice, and the results back up what we've long believed. We built the first value-based care contracts for NPs with major payors, taking on real financial risk for outcomes. In our anchor market in New Hampshire, our network outperformed the state on total cost of care by 19%, proof that a solo NP in an underserved area can outperform a system ten times their size and get rewarded for it.

As a Senior Product Engineer on Billing Operations, you'll own the engineering behind Duet's revenue cycle products. You'll build the systems that move a claim from charge capture through submission, adjudication, denial, appeal, and collection, across three surfaces:

• internal tooling our billing operators depend on

• automation that replaces manual claims and denials work

• customer-facing products clinic staff use every day

This is a deeply hands-on, full-stack role with backend as your center of gravity. You’ll own reliability of API connections between billing systems and clearinghouses, work with data to ensure data accuracy, and build dashboards that our customers and internal ops team consumes.

You'll work closely with our billing operations and product teams, partnering with people who do this work manually today to turn their hard-won knowledge into durable software.

Build the connections that move billing data. Design and build the integrations that link practice management systems, our cloud data warehouse, and clearinghouses—standing up new connections as we onboard practices and partners, and extending the pipelines that carry claims, remittance, and payment data end to end.

Keep those connections reliable. Harden the integrations we already run so data keeps flowing when source systems change, APIs throttle, files malform, or clearinghouse transactions fail. Build the monitoring, alerting, and observability that catch breakage before a practice's cash flow does. Share on-call and incident response with the team, and turn every incident into a durable fix. When money stops moving, this is the work that gets it moving again.

Build customer-facing billing products. Design and ship the dashboards, worklists, and workflows that clinic staff use to manage their revenue cycle—claims status, denials, collections, charge review, and payer performance. Make complex billing data usable and trustworthy for people who aren't billers by training.

Automate the claims and denials lifecycle. Identify the repetitive, rule-driven work in claims submission, denial management, and appeals, and replace it with configurable, rule-based automation. Build systems that scrub claims before they go out, route denials intelligently, and turn human-in-the-loop processes into self-serve software.

Own quality across the board. Write thoughtful tests for integration and billing logic, where correctness is non-negotiable. Debug production issues, and ensure changes are safe, observable, and reversible. You set the bar for what production-ready means—both for the products you ship and the connections you keep alive.

• 5–8 years of experience building production web applications, with a track record of owning significant technical surface area end to end.

• Direct experience with healthcare billing, claims, or revenue cycle management. You understand the claims lifecycle—submission, adjudication, denials, appeals, collections—and the rules and data structures behind it (e.g., CPT/ICD coding, EOBs/ERAs, clearinghouses, payer-specific requirements).

• Strong backend and data engineering instincts. Our products ingest, process, transform, and serve data at the application layer.

• Proficiency in Python and JavaScript, with experience designing and building RESTful APIs.

• Full-stack capability with backend as your center of gravity. You're as comfortable modeling data and writing performant queries as you are building the UI layer that makes that data useful.

• Experience with cloud data warehouses and modern data tooling.

• A product engineering mindset—you think about what you're building from the user's perspective, not just the system's.

• High ownership, comfort with ambiguity, and a bias toward shipping.

Experience integrating with specific EHR or practice management systems, or with clearinghouses, maps directly to what we're doing. Familiarity with workflow automation or rule-based systems is a strong plus. Exposure to value-based care or programs like APCM (Advanced Primary Care Management) will accelerate your impact. So will experience turning internal tools or managed services into self-serve customer-facing products.

Python and React/Next.js, RESTful APIs, cloud data warehouse.

This role is hybrid in NYC (in office Monday-Wednesday). The salary range for this role is $160,000-$185,000 per year plus equity.