Who is Recruiting from Scratch:
Recruiting from Scratch is a specialized talent firm dedicated to helping companies build exceptional teams. We partner closely with our clients to deeply understand their needs, then connect them with top-tier candidates who are not only highly skilled but also the right fit for the company’s culture and vision. Our mission is simple: place the best people in the right roles to drive long-term success for both clients and candidates.
Title of the Role: Machine Learning Engineer
Location: New York, NY
Company Stage of Funding: Early-Stage, Venture-Backed AI Healthcare Startup
Office Type: 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
- 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