Software Engineer

Decodahealth
Toronto Office
On-site

Who this role is best for

Best suited to mid-level full-stack engineers who thrive in startup environments and have experience in healthcare or fintech domains.

Best fit for

  • Engineers comfortable with ambiguity and end-to-end ownership in a fast-growing startup.
    — “you'll scope problems, talk to users, write the code, ship it, and watch how it lands
  • Candidates with strong full-stack skills and a bias for shipping quickly.
    — “you'd rather get something real in front of users and iterate than polish in isolation
  • Developers who enjoy integrating AI into real-world workflows.
    — “Integrate and productionize AI capabilities (agents, ambient scribing, automated follow-ups) into real clinical and front-desk workflows

Things to consider

  • Expect to work across multiple domains including payments, messaging, and clinical documentation.
    — “the work spans real-time patient communication (voice, text, and document), payments and billing infrastructure, EMR workflows like charting and scheduling
  • High standards for correctness and uptime in critical systems.
    — “where correctness and uptime are non-negotiable

How to stand out

  • Highlight specific examples of shipping features end-to-end in previous roles.
    — “Design, build, and ship full-stack features end-to-end — from data model to API to UI
  • Demonstrate experience working directly with customers to solve ambiguous problems.
    — “Work directly with customers and the founders to turn ambiguous problems into shipped product
  • Showcase any production experience with AI integrations or real-time systems.
    — “Hands-on work integrating LLMs or AI agents into production products
Pace · Fast PacedCollaboration · MediumAutonomy · HighDecision Impact · TeamLevel · Mid

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • designing and shipping full-stack features
  • building and hardening infrastructure
  • integrating AI capabilities
  • working directly with customers
Typical background
3+ years of experience building and shipping production software

Skills & requirements

Required

Full-stack DevelopmentAPI DevelopmentData ModelingReal-time SystemsCloud InfrastructureCI/CD

Preferred

Healthcare ExperienceAI IntegrationLlms

Stack & domain

Ai-native Operating SystemReal-time Patient CommunicationPayments And Billing InfrastructureEmr WorkflowsAi AgentsCommunicationProblem-solvingOwnershipTeamworkHealthcareFintech

About the role

Original posting from Decodahealth via Ashby

SOFTWARE ENGINEER

Decoda Health · Full-time · Toronto

ABOUT DECODA

Decoda is the all-in-one, AI-native operating system for modern elective-care clinics — med spas, wellness, longevity, and aesthetics practices. Most clinics run on 5–10 disconnected tools that don't talk to each other; we replace all of them with a single platform: scheduling, charting, billing, payments, memberships, inventory, and patient communication in one place, with AI built into every workflow — an AI front desk that books patients 24/7, an ambient scribe that writes clinical notes in real time, and automated follow-ups that keep calendars full.

We're a Y Combinator (S23) company. We're live in 200+ clinics, processing $150M+ in annual transactions, and we've grown more than ten-fold in the last six months. We're a small team that has consistently out-shipped incumbents many times our size, and we're hiring engineers who want that kind of leverage.

THE ROLE

As an early engineer at Decoda, you own meaningful surface area from day one. You'll work across the stack to ship product that clinic staff use every hour of every day — and that directly moves revenue, patient experience, and clinical efficiency for our customers. This is a build-and-own role: you'll scope problems, talk to users, write the code, ship it, and watch how it lands.

Because we're small and the platform is broad, the work spans real-time patient communication (voice, text, and document), payments and billing infrastructure, EMR workflows like charting and scheduling, and the AI agents that sit on top of all of it. You won't be boxed into one corner of the codebase.

WHAT YOU'LL DO

  • Design, build, and ship full-stack features end-to-end — from data model to API to UI — that clinics rely on daily.
  • Build and harden the infrastructure behind payments, patient messaging, and clinical documentation, where correctness and uptime are non-negotiable.
  • Integrate and productionize AI capabilities (agents, ambient scribing, automated follow-ups) into real clinical and front-desk workflows.
  • Work directly with customers and the founders to turn ambiguous problems into shipped product, often within days.
  • Own quality: write tests, instrument what you ship, and fix things fast when they break.
  • Help set the technical foundations — patterns, tooling, and standards — that the next 20 engineers will build on.

WHAT WE'RE LOOKING FOR

  • 3+ years building and shipping production software, ideally at a startup or on a small team where you owned features end-to-end.
  • Strong fundamentals in a modern backend language and a typed frontend stack; comfortable moving across the full stack.
  • Solid grasp of data modeling, APIs, and relational databases (SQL).
  • A bias for shipping — you'd rather get something real in front of users and iterate than polish in isolation.
  • Comfort with ambiguity and a sense of ownership; you treat "is this someone's job?" as "this is my job."
  • Clear written and verbal communication, and a genuine interest in talking to the people who use what you build.

NICE TO HAVE

  • Experience in healthcare, fintech/payments, or another regulated, high-trust domain.
  • Hands-on work integrating LLMs or AI agents into production products.
  • Familiarity with cloud infrastructure (GCP), containerization (Docker/Kubernetes), and CI/CD.
  • Real-time systems experience (voice, messaging, event-driven architectures).
  • Early-stage startup experience and a track record of high output with a small team.

WHY JOIN

  • Leverage. AI gives tiny teams massive reach. Your code ships to 150+ clinics and shows up in real revenue and saved hours.
  • Ownership. You'll have outsized influence on the product, the architecture, and the culture this early.
  • Momentum. A growing, profitable-trajectory business in a category we're positioned to define, backed by YC.
  • Real impact. You're freeing clinical teams from busywork so they can focus on patients.

Source: Decodahealth careers (Ashby)

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