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Software Engineer

Onsite or remote • New York City+1💼 Full-time🗓 2026-06-24

Core

Building the core product for an operational OS for injury care practices, starting with medical billing.

Role type

Early-stage software engineer (first hire)

Builds

Core product for medical billing and operational workflows

Domain

Healthcare / Medical billing

Deliverable

product features

Required skills

shipping real products, owning products, early-stage experience, understanding user problems, talking to non-technical domain experts

Responsibilities

Building the core product end-to-end, making technical decisions, understanding billing workflows

Seniority

Early-stage, hands-on IC

Rewrite
## About the role Acalia is building the operational OS for injury care practices, starting with medical billing. Independent specialty practices bleed time and money on healthcare software that was never built for the way their specialty actually works. The result: high-stakes, rules-heavy, deeply manual workflows that nobody has truly automated. We're changing that. We're early and moving fast: live pilots, signed LOIs across multiple specialties, and real revenue conversations with larger medical service groups. You'd be our first engineering hire, building the core product alongside the founders. You'll own a surface end to end, make real technical decisions, and, potentially, spend some time understanding the billing workflows we're rebuilding, because that's where the hard problems actually live. ## Who you'd work with The founders are technical and product-obsessed. Our CTO previously built automation for high-stakes manual workflows at Palantir, Anyscale, and Citadel. ## You might be a fit if you - Have shipped real products and owned them, ideally at an early stage. - Care more about the user's actual problem than the elegance of the solution. - Are comfortable talking to non-technical domain experts and understanding their problems
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