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Founding Engineer

Onsite or remote • San Francisco+3💼 Full-time🗓 2026-06-24

Core

Building AI-driven ambient documentation, pre-bill error catching, intelligent claims, and automated denial systems for ambulance agencies to fix payment processing.

Role type

Founding Engineer (AI/Healthcare)

Builds

Customer-facing AI features for claims automation and documentation

Domain

Healthcare (Ambulance/Emergency Services) + AI/LLMs

Deliverable

production ML models | product features

Required skills

Agentic AI systems, LLMs, RAG architectures, Fullstack development, React, UX design

Preferred skills

None stated

Technologies

LLMs, RAG, React

Responsibilities

Talk to billers, fire chiefs, and ops leaders; Build customer-facing features; Own end-to-end architecture, code, and deployment; Ship automation to save agencies money

Seniority

Founding, hands-on IC

Rewrite
## About the role Beyond that one anecdote about your friend in college who got a $4K bill in the mail, have you ever thought about how an ambulance gets paid? Ambulance agencies lose ~$40B a year to a maze of payor rules and denied claims. Billers copy-paste between tabs. Documentation gets rejected for missing fields no one told them about. Denials pile up because no one has time to fight them. Paramedics run the call, save the life, and the agency eats the cost. We're building the AI that fixes this: ambient documentation, pre-bill error catching, intelligent claims, automated denials. We're live with customers, closing our first $1M ARR, and backed at pre-seed by Eniac and Euclid Ventures. ## The team We're two people who move fast and own outcomes and want to build a small, elite team. Ayla was a healthcare investor and EMT in Alameda County. August was founding engineer doing voice and AI in healthcare at Commure, Simbie, and Paratus. We started Ambra because EMS is the rare industry where good software directly protects the 911 service people call on their worst day. We're obsessed with craft, real customer impact, and replacing legacy systems with software that works. We're hiring a founding engineer. ## About you You have an opinion and know when to push back. When a customer asks for X, you figure out whether they need X or something three steps upstream. You ship, feel good for thirty seconds, then notice what could be better. You want to start a company someday. You want a true founding seat with meaningful equity. You want to build something that matters in an industry AI hasn't touched yet. ## What you'll do This role takes a specific kind of engineer: an architect, technically rigorous, opinionated, energized by customer conversations. You'll talk to billers, fire chiefs, and ops leaders. Build customer-facing features. Own end-to-end: architecture, code, deployment, the 2am page. Ship automation that saves agencies millions and gets paramedics paid…and have fun with us. ## Must-haves - Excellent at building agentically. You have 10+ agents running at all time. You love to stay on top of new developments in AI building - 1-3 years building fullstack products end-to-end - High bar for quality, attention to detail, obsessively fast learner, clear communicator - APIs, LLMs, RAG architectures - React + design/UX sensibilities (you know what good product looks and feels like)
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