Senior/Staff Backend Engineer

About the Role

 We're seeking an experienced C# .net + SQL Server developer to join our growing medical billing technology company as a key technical leader. This is an exciting opportunity to shape our technical direction while helping build out our team and future office presence. You'll work with cutting-edge healthcare technology, designing scalable solutions.

What You'll Do

• System Architecture & Design : Lead architectural decisions for complex medical billing systems and data infrastructure
• Greenfield Development : Lead the design and architecture of our new medical billing platform from the ground up
• System Integration : Design integration strategies for migrating data and workflows from existing low-code/no-code platforms (Salesforce, QuickBase, SharePoint and others)
• Data Pipeline Architecture : Design and oversee ETL processes, data warehousing solutions, and business intelligence systems
• Team Building : Help establish and grow our technical team as we scale, including future office planning
• Cross-functional Collaboration : Work closely with business stakeholders to translate complex healthcare billing requirements into technical solutions

Required Qualifications

• 8+ years of software development and architecture experience

• Expert-level proficiency in:

1. .NET ecosystem (C#, ASP.NET)
2. SQL Server (stored procedures, triggers, performance optimization)
3. SSIS (ETL development and data integration)
4. Cloud infrastructure (AWS, Azure, or GCP)

• Proven experience with:

1. Data warehouse environments and BI solutions
2. Greenfield system design and implementation
3. System integrations and data migration from third-party platforms
4. Team leadership and/or technical mentoring

• Strong analytical skills with attention to detail and data accuracy
• Excellent communication skills for stakeholder engagement and technical documentation
• Fluent English
• Availability for meetings in EST

Preferred Qualifications

• Experience in healthcare, financial services, or regulated industries
• Integration experience with low-code/no-code platforms (Salesforce, QuickBase, SharePoint)
• Power BI experience for business intelligence and reporting
• Agile/Scrum methodology experience
• Python experience for data analysis and automation
• Software Engineering degree or equivalent experience

Company Culture

Teamwork is at the heart of everything we do. We believe the best solutions come from strong teams. Our culture values detail-oriented professionals who are passionate about data and technology excellence, while fostering an environment where team members speak up, challenge thinking constructively, and put collective success first.

We thrive on solving complex technical challenges together, maintaining the highest standards of accuracy and performance—critical in the healthcare billing space. You'll join a team that celebrates collective wins, supports each other through challenges, and builds something meaningful together.

Next Steps

If you're excited about architecting solutions that improve healthcare operations while building something meaningful from the ground up, we'd love to hear from you at techhiring [at] mdcapitaladvisors [dot] com