Senior Software Engineer

About this role

## About Fathom

Fathom is on a mission to eliminate the billions of dollars of administrative waste in US healthcare. We're starting with one of its most expensive, labor-intensive workflows: medical coding. Using AI, we automate the translation of clinical notes into the billing codes used for provider reimbursement—a process that costs US hospitals $15B+ annually, plus tens of billions more in errors and denied claims.

The result is healthcare that spends less time and money on administration and more on what actually matters: patients. KLAS named us the #1 emerging technology for reducing the cost of care, and many of the nation's largest health systems, health plans, and physician groups rely on us to do it.

We're a Series B company backed by Lightspeed, Founders Fund, and CVS Health—taking on hard problems at the frontier of AI and healthcare, where getting it right has real consequences. We're scaling fast and looking for exceptional people who want their work to matter.

## About the role

We are hiring a Senior Software Engineer to build the products and infrastructure at the core of that system. This is an agentic engineering role. You will direct fleets of coding agents—Claude Code and Codex—and orchestrate them to amplify your output. Your job is to architect, direct, review, and ship at a scale no individual coder reaches alone.

We operate agent-first. The mandate extends beyond automating output generation for our customer base. We are driving toward full automation of customer onboarding as well—turning what is today human-intensive integration and ramp work into agent-executed pipelines.

Hybrid only with 3 days in office weekly. New York City (Manhattan Financial District), Oakland, or Austin.

## What you’ll do

• Orchestrate agent fleets to design, build, and ship data infrastructure that ingests, sanitizes, and normalizes a broad range of medical data—electronic health records, journals, established medical ontologies, ...