Machine Learning Engineer

Recruiting from Scratch; New York (NY); Hybrid; USD 140,000 - 190,000; Full time

Job summary

Recruiting from Scratch is partnering with an early-stage AI healthcare startup in New York to build end-to-end ML systems for medical coding and revenue cycle workflows. We’re seeking a Founding AI Engineer to own core AI systems from data ingestion to production deployment.

This hands-on role offers meaningful equity upside and a hybrid office schedule. You will design RAG systems, tune LLMs, and work with GCP-based infrastructure, EHR integrations, and healthcare data, in a fast-paced startup

Qualifications

• 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.

Responsibilities

• Design and build RAG systems over clinical notes, billing data, and coding guidelines.
• Adapt and fine-tune LLMs 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.

Skills

LLM + RAG in prod

Model adaptation / fine-tuning

Data ingestion & production deployment

GCP infrastructure

Tools

Vertex AI

BigQuery

GKE

Cloud Run

Pub/Sub

Job description

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.

https://www.recruitingfromscratch.com/

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