Machine Learning Engineer

Who is Recruiting from Scratch:

Recruiting from Scratch is a premier talent firm that focuses on placing the best product managers, software, and hardware talent at innovative companies. Our team is 100% remote and we work with teams across the United States to help them hire.

About the client:

Location: New York City (Hybrid; some weeks may require up to 5 days/week in-office, other weeks only 1 days but we average 3 days a week)
Role Overview

We're an early-stage, venture-backed startup building AI systems for medical coding and revenue cycle workflows. We're looking for a Founding AI Engineer to take end-to-end ownership of core AI systems-from data ingestion and retrieval to model adaptation and production deployment.

This is a hands-on role in a fast-paced environment with high responsibility and meaningful equity upside.
What You'll Work On

• Design and build RAG systems over clinical notes, billing data, and coding guidelines
• Adapt and fine-tune LLMs (LoRA/QLoRA, instruction tuning) for medical coding and explanations
• Help architect and operate GCP-based infrastructure (Cloud Run/GKE, Vertex AI, BigQuery, Pub/Sub)
• Build evaluation and feedback loops to measure accuracy and quality
• Own integrations with EHRs, RCM systems, and other healthcare data sources

What We're Looking For

• Experience building and shipping LLM + RAG systems in production
• Hands-on experience with model adaptation or fine-tuning techniques
• Strong backend engineering skills (Python, TypeScript, or similar)
• Comfortable working with messy, real-world data and production systems
• Ownership mindset and ability to move quickly in an early-stage startup

Nice to Have

• Healthcare, EHR, or medical coding experience (ICD-10, CPT, HCPCS)
• Experience handling PHI and working in HIPAA-regulated environments
• Familiarity with Vertex AI or high-performance inference
• NYC-based or able to be in-office periodically

Compensation

• Base Salary: $120,000 - $150,000
• Equity: Meaningful early-stage equity