Senior Back-end / Full-Stack Engineer

Senior Back-end / Full-Stack Engineer

Ekko | Full-time | Chennai | Reporting to the CTO

About Ekko

Ekko is an AI-powered healthcare product that turns clinical conversations into structured

documentation. Our pipeline transcribes audio, generates clinical notes, and extracts structured data using LLMs. We ship a web app and a backend service used by clinicians who depend on getting it right.

We're a small, early-stage team that cares a lot about craft, moves fast, and keeps the chai flowing. The person in this role won't just keep the lights on. You'll shape how our backend scales.

The Role

We're hiring a Senior Back-end / Full-Stack Engineer to own the service that powers Ekko. You'll work on the core NestJS / TypeScript backend that streams audio, orchestrates transcription, runs our LLM pipeline, and turns a messy real-world conversation into clean structured data.

This is the heart of the product. Audio comes in, structured documentation comes out, and it has to be fast, reliable, and correct. You'll design the APIs, own the data model in Prisma, handle real-time streaming over WebSockets, and wrangle the speech and LLM providers our pipeline leans on. This is a senior, hands-on role. You'll ship production code from week one, set the backend standards, and step into the front-end when a feature deserves end-to-end ownership.

What You'll Do

Own the core backend service

·      Build and scale our NestJS / TypeScript backend

·      Design and maintain the data model with Prisma

·      Build real-time audio streaming and event flows over WebSockets (socket.io)

·      Manage caching, queues, and performance with Redis

Run the AI and audio pipeline

·      Integrate and orchestrate speech-to-text providers (AWS Transcribe, Google Speech, Azure

·      Speech)

·      Build and harden the LLM steps that generate notes and extract structured data (OpenAI and

·      similar)

·      Design for reliability: retries, fallbacks, and graceful degradation when a provider has a bad day

Build clean, secure APIs

·      Design REST and WebSocket APIs the web app consumes

·      Implement auth and access control (Auth0 / JWT) for sensitive clinical data

·      Document APIs (Swagger) and keep contracts stable

Operate like an owner

·      Set standards for testing (Jest), error handling, and observability

·      Handle AWS infrastructure (S3, SES, Lambda, CloudFront) pragmatically

·      Step into the React / TypeScript front-end to deliver features end to end

What You Bring

·      5+ years building production backends, with at least 2 years in a senior or lead capacity

·      Strong Node.js and TypeScript, ideally with NestJS (or comparable frameworks like Express)

·      Solid data modeling and SQL, with an ORM such as Prisma

·      Experience with real-time systems (WebSockets, streaming, event-driven flows)

·      Experience integrating third-party APIs at scale, especially AI/LLM or media/audio services

·      Comfort with cloud infrastructure (AWS preferred) and caching layers (Redis)

·      Comfort working full-stack in a React / TypeScript front-end when needed

·      Comfort with startup life: ambiguity, ownership, and shipping over perfection

Nice to Have

·      Experience building or operating LLM pipelines in production

·      Healthcare or other high-trust, accuracy-critical software experience

·      Familiarity with HIPAA, NABH, DPDP, or similar compliance frameworks

·      Audio/media processing experience (streaming, transcription, ffmpeg)

·      CI/CD experience (GitHub Actions)

·      A strong stance in the tabs vs spaces debate (we promise to respect it, mostly)

·      Serious foodies welcome; debugging always goes better over good food

·      Bonus if you can drop the perfect Rajinikanth dialogue at the exact right moment in code review

What We Value

These are the values we hire for and live by:

·      People First, Always. Empowered, supported people build transformative solutions, so we invest in our team.

·      Build with Empathy. We understand the pain points of clinicians and patients, and design solutions that feel intuitive and add real value.

·      Pursue Practical Innovation. We innovate with purpose, not novelty, grounded in reliability, simplicity, and outcomes.

·      Move with Humility and Urgency. We're ambitious about hard problems but stay grounded in feedback. We ship fast, learn quickly, and adapt.

·      Think Long-Term, Act Today. We're building a platform for the future of healthcare, making decisions with tomorrow in mind without losing momentum today.

·      Win Together. Great outcomes come from collaboration. Teammates, customers, or partners, we listen, share, and grow as one.

Why Join

·      Real ownership. You're shaping the core service Ekko runs on, not patching legacy code.

·      AI product depth. You'll build and harden a real LLM pipeline in a clinical setting, problems most

·      backend roles never get to touch.

·      Direct impact. Small team, fast feedback, decisions made in days not quarters.

·      Good people. We take the work seriously and ourselves a lot less so.