Sr. Coding Implementation Engineer

At Commence, we’re the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient process to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care. 

With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.  

Commence is seeking a Sr. Coding Implementation Engineer to assist in the deployment of our medical coding platform alongside our customers, and to serve as the internal technical anchor for the practice. This is a unique hybrid role for a technical professional who sits at the intersection of healthcare data engineering and medical coding. This role carries the most complex implementations as primary technical owner and, equally important, converts what is learned on each one into documented capability the next engagement can reuse. 

• Serve as primary technical owner for customer implementations, from data discovery through side-by-side validation, go-live, and stabilization.
• Lead source-to-target data mapping and interface definition with customer IT and revenue cycle teams, and make the calls on scope, sequencing, and what is a customer obligation.
• Design and configure coding logic for complex customers: multi-specialty surgical programs, high modifier complexity, non-standard documentation patterns, and payer-specific rule sets.
• Define the side-by-side validation methodology, including sampling approach, discrepancy taxonomy, acceptance thresholds, and the evidence required to declare production readiness.
• Diagnose accuracy failures to root cause across the full stack: source data, ingestion, mapping, rules, and model behavior, and hold partner engineering to resolution with reproducible cases.
• Build and maintain the internal knowledge base: runbooks, configuration patterns, validation tooling, and onboarding material for new Implementation Consultants.
• Mentor and technically direct junior Implementation Consultants without owning their formal performance management or task assignment.
• Write SQL, operate in AWS, manage configuration in Git, and make bounded changes to Java rule and integration components as a hands-on practitioner, not in a purely oversight capacity.
• Represent Commence in customer executive conversations on implementation status, accuracy results, and risk, and hold credibility with clinical, revenue cycle, and IT leadership.
• Provide implementation feasibility and level-of-effort input into new customer pursuits, including what is deliverable in a given timeline and what is not.

Required Qualifications

• 6+ years implementing healthcare software at provider organizations, including at least two full-cycle implementations owned end to end as primary technical resource.
• Substantive medical coding knowledge with direct surgical and procedural coding experience: CPT, ICD-10-CM and PCS, modifier application, NCCI edits, global periods, and operative note documentation.
• Advanced SQL, including performance-conscious querying against large tables, and the ability to design reconciliation and validation queries rather than only run them.
• Hands-on AWS experience across S3, RDS, EC2, CloudWatch, and IAM, with working understanding of environment segregation and PHI handling controls.
• Git-based workflow ownership: branching strategy, pull request discipline, and review of others' configuration changes.
• Ability to read Java, trace behavior through existing rule and integration components, and make bounded changes under Engineering review.
• Demonstrated pattern recognition at scale: a track record of finding the systematic cause behind a large discrepancy population and quantifying its impact.
• Detail orientation with evidence behind it, from a role where accuracy carried financial, clinical, or compliance consequences.
• Demonstrated ability to hold both an engineering conversation and a customer executive conversation credibly, and to own a customer relationship without escalation as the default.
• Bachelor's degree, or four additional years of relevant experience in place of a degree.

Desired Qualifications

• AAPC or AHIMA credential: CPC, COC, CCS, or CIRCC, with surgical specialty experience.
• Epic or Cerner experience, particularly Epic Resolute Professional or Hospital Billing, OpTime, or Clarity and Caboodle reporting.
• Experience with healthcare data standards including HL7 v2, FHIR, and X12 837 and 835.
• Prior work with computer-assisted coding, autonomous coding, or NLP-based clinical documentation platforms.
• Experience running a parallel-run or side-by-side validation against a legacy process.
• Python for data analysis and validation scripting.
• Ambulatory surgery center or multi-specialty surgical group experience.
• Experience implementing on behalf of, or in partnership with, a third-party software vendor.

Work Environment/Physical Demands

The work environment and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This is an office/remote position. While performing the duties of this job, the employee regularly works in a climate-controlled environment. Candidates must be able to sit, read, work on a computer, and watch a computer screen for extended periods of time. Occasionally required to stand, walk, use hands and fingers, kneel or crouch. This is a remote position. Candidates must be able to sit, read, work on a computer, and watch a computer screen for extended periods of time. Occasionally required to stand, walk, use hands and fingers, kneel or crouch. Commence is an equal employment opportunity employer. All personnel processes are merit-based and applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military and veteran status or any other characteristic protected by applicable law. Commence.AI is committed to providing equal employment opportunities to all applicants, including individuals with disabilities. If you require a reasonable accommodation to participate in the application process due to a disability, please contact Human Resources at (757) 306-4920 or hr@commence.ai. Please note that unless you are requesting an accommodation, all applications must be submitted through our online application system.