Clinical Software Engineer Jobs in Missouri (NOW HIRING)

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

You’ll build AI-native software that makes medical billers dramatically more productive. Billing in America is a messy, meticulous, and a largely manual process. Hospitals have to throw huge administrative teams at it, and small practices bleed cash flow as they struggle to use outdated tools.

Our team, Air Billing, is behind the highest-traffic surfaces in our practice management product: claims, appointments, and payments posting— the workspaces billers and practice staff live in all day. These aren't basic CRUD screens; they’re fast, data-dense, keyboard-driven workflows over millions of claims, sitting on real healthcare plumbing (EDI transactions, payer automations). AI is central to how we drive productivity, but we don't solve everything with an agent. We only put LLMs in the loop where day-to-day friction is highest.

We're mid-way through a generational rebuild of these surfaces, and of the frontend and backend architecture beneath them, to keep pace with the company's growth. As a Staff Software Product Engineer, you'll set the technical direction for that rebuild—across multiple teams, not within a single one. Our stack is React 19 / TypeScript on the frontend and Python/FastAPI + PostgreSQL on the backend, with a columnar warehouse for analytics.

What You’ll Do

This is a staff-level role: your job is to raise the ceiling for every team building biller workflows, not to be the fastest individual contributor.

• Set the technical direction for the biller-workflow platform—the frontend and backend architecture that multiple teams build on and drive it to adoption across the RCM engineering org
• Establish the standards and patterns other teams follow: component and design-system conventions, data-fetching and API contracts, testing, and observability practices that keep a large, multi-team frontend consistent and fast
• Lead the hardest cross-cutting problems end to end, partnering with the teams that own them:
  • Data-dense tables at scale—server-side grouping, filtering, and virtualized rendering over millions of records
  • Idempotent, queue-backed bulk operations that safely mutate tens of thousands of records with undo and auditability
  • A unified claim activity timeline across submissions, payer status, remittances, appeals, and prior auth
  • Embedding AI where it removes real friction—claim comparison, submission-error reasoning, and rule suggestions
• Ensure engineering excellence across teams through architecture reviews, deep code review, and mentorship that levels up engineers beyond your immediate team
• Own reliability and performance in production for these surfaces—render and query performance, replica-lag handling, and the health of claim-submission pipelines
• Partner with product, design, and billing operations to turn the messiest parts of the billing workflow into software, with feedback loops measured in days, not quarters

What You Have

• 8+ years building large-scale, full-stack applications—setting technical direction and raising the bar across multiple teams
• Org-wide frontend leadership— you’ve orchestrated the adoption of a design system or shared component architecture across a large organization, established the best practices and patterns behind it, and ensured engineering excellence across multiple teams contributing to one frontend.
  • You can still go deep: diagnosing and fixing React rendering bottlenecks in complex, data-dense UIs
• Strong API and data-layer design— you set the conventions for REST endpoints handling filtering, grouping, and pagination over large datasets, and know how to optimize the queries behind them
• A track record leading multi-month, multi-team initiatives— you’ve driven a large migration or platform rebuild across several teams and shipped it incrementally without breaking users
• A force multiplier— you define conventions, review broadly, and mentor engineers across teams to raise the technical bar
• Strong debugging and observability instincts— monitoring, logging, and alerting best practices
• Excellent communication— you can align both leadership and multiple engineering teams around a shared technical direction
• Ownership mindset and strong bias for action— you’ve owned meaningful product surfaces and driven ambiguous work to completion in an unstructured environment
• Deep expertise in TypeScript/React, Python, and PostgreSQL

Nice to Have

• Experience with analytical/OLAP stores (StarRocks, ClickHouse, Druid) alongside transactional PostgreSQL
• Familiarity with healthcare billing data— EDI X12 (270/271, 276/277, 835, 837), clearinghouses, ERAs/EOBs, denial codes—or a demonstrated ability to master a gnarly domain quickly
• Experience shipping LLM-powered features into production workflows, not just demos
• Strong product intuition with a track record of influencing UX/UI decisions to improve usability
• Experience with developer tooling and CI/CD pipelines for frontend applications
• Experience working in highly regulated industries (healthcare, finance, insurance) with a focus on security and compliance
• A passion for improving healthcare and healthcare operations in America

Why Join

• Shape the technical foundation that many teams—and thousands of practices—build on, in a product billers use for hours every day
• Work on hard, satisfying full-stack problems: data-dense UI performance, bulk operations at scale, event timelines, EDI plumbing, and agents embedded in real workflows
• Define what best-in-class billing software looks and feels like—our differentiation is workflow speed and polish
• Set standards and mentor across an engineering org that's scaling fast, with tight feedback loops from in-house operators
• Join mid-rebuild, when the architecture, conventions, and team culture are still highly shapeable