Founding Engineer

Who are we?

Paxos Appeals empowers patients facing high-cost medical treatments to secure the health insurance coverage they deserve. Our tech-enabled service uses AI to write appeals for patients after their health insurers deny coverage for medical treatments. Our customized, 15+ page appeals utilize the patient’s documentation, insurer's own clinical policy language, medical literature, regulations, precedent, and more.

Background: Approximately 15% of all health insurance claims are denied, and denial-rates rose by 18% from 2020 to 2023, in part due to insurance companies weaponizing AI to deny claims. Less than 1% of patients appeal their denials, yet over 40% of those appeals are successful. (And our appeals have a denial-overturn rate of >90%.)

Our progress: So far, we've won patients over $2M in health insurance coverage. We’ve been operating since May 2023, starting as a revenue-generating bootstrapped services business. We won the Stanford Impact Founder and IDIF fellowships, as well as seven startup competitions. We've established six partnerships with healthcare providers and seven partnerships with health insurance attorneys. Here is a Stanford article about us. 

Who are you?

We are seeking an ambitious individual who is passionate about our mission to help patients, excited to work in a fast-paced early startup environment, comfortable with ambiguity, and ready to take on the challenge of building our tech stack from 0 to 1. 

You see the bigger picture and are eager to contribute to product development, strategy, and operational efficiency. 

Job Responsibilities

• Technical leadership to inform product development: Set the technical direction of the company. Offer technical expertise and support to the team, resolving complex issues as they arise. Contribute to the overall company strategy.

• AI capabilities: Explore and implement generative AI solutions for our service offerings. This will involve Retrieval-Augmented Generation (RAG), advanced prompt engineering, and web and phone agents. Foundational model training won’t be necessary.

• Manual workflow automation: Apply off-the-shelf tools, APIs, or custom software to automate manual processes.

• Tool evaluation and selection: Evaluate and recommend new tools and technologies that can improve our capabilities. We want to use as many pre-built tools as practical during this early stage, and we’ll build more capabilities in-house as we scale up. 

• Other elements based on your learning goals: If there are other aspects of the company you’re interested in working on, we’d love to involve you!

Currently, we are operating our service using a combination of manual and automated workflows using off-the-shelf tools. For our next set of systems, we’re planning on using Langchain, Retool, and specialized AI offerings (RAG, web agents, phone agents, etc.), and we’d love your thought-partnership on this as you ramp up at the company. 

Qualifications

We’re open to adjusting the below requirements for the right candidate. Internships and side-projects can count towards these requirements. 

Required qualifications:

1. Minimum of 1 year software engineering experience

2. Ability to work in person at least 4 days per week on average in NYC or San Francisco

3. Entrepreneurial spirit: self-starting, scrappy, growth mindset, ability to collaborate with a team, comfort with ambiguity and constant change 

Preferred qualifications: 

1. 3+ years of software engineering experience

2. Experience working at an early-stage startup

3. Experience streamlining/automating manual workflows

4. Experience building a tech-enabled service

5. Experience applying AI in business and operational contexts, including RAG apps, prompt engineering, AI pipelines, etc. (foundational AI experience not necessary)

6. Experience building products or services in the healthcare industry, or even better, healthcare revenue cycle management

Compensation

Competitive salary plus a generous equity package, commensurate with candidate’s qualifications and experience. Strong health benefits (medical, dental, vision).

More on our company

Our founding team: We come out of Stanford, with Haley and Alex receiving MBAs and Malcolm receiving a B.S. in Human Biology. Previously, Haley was an engineer in the healthcare industry, and Alex was a product manager at Meta and Microsoft and a serial startup founder. All three team members have significant experience working with engineers and other technical teammates, and we place strong value in those team-members. See our About Us page for more details on our team.

This is a deeply personal mission for us. In 2021, Alex was denied by insurance for a $40,000 medical procedure and had to resort to Reddit where an anonymous user, who also had previously successfully appealed their denial, helped Alex write his appeal. That anonymous user’s advice worked: Alex won his appeal! Later, at Stanford, Alex met Haley, and they decided to start a venture to help patients navigate health insurance appeals, driven by Alex’s personal experience. Soon, Alex and Haley discovered another Stanford student was working on a similar project. It turns out, that Stanford student was the same anonymous Reddit user that had helped Alex in 2021: Malcolm. They decided to join forces and have been working together on Paxos Appeals ever since. 

Vibes: We’re an early-stage startup and you can therefore expect a fast-paced, dynamic, and exciting working environment.