Accounting & Finance Operations Manager

Overview

This role involves owning day-to-day accounting and finance operations, strengthening financial processes and controls, and optimizing cash flow through improved accounts receivable performance. You will oversee an external accounting partner and work across systems and integrations supporting billing, payroll, spend management, prefunded patient exam cards, and reporting.

Reporting to the VP of Finance, this is a hands-on position focused on scaling financial operations as the organization grows.

Responsibilities

• Own the end-to-end accounts receivable process, including:
  • Customer invoicing
  • Cash application
  • Collections
  • Dispute resolution
  • Aging reporting
• Monitor and optimize receivables performance, including:
  • Days sales outstanding (DSO)
  • Collection timelines
  • Reimbursement trends across customers and payers
• Manage financial operations of prefunded patient exam cards through Lithic, including:
  • Funding
  • Reconciliation
  • Reimbursement tracking
  • Cash exposure
• Own payroll administration through Rippling, including:
  • Payroll processing
  • Employee changes
  • Deductions
  • Tax reconciliations
  • General ledger integrations
• Administer Ramp, including:
  • Corporate card programs
  • Expense policies
  • Approval workflows
  • Spend limits
  • Compliance monitoring
• Partner with the external accounting firm to manage the monthly close process, including reviewing reconciliations and accruals and ensuring accurate, timely financial reporting
• Oversee the day-to-day relationship with the external accounting partner, including deliverables, service expectations, process improvements, and accountability
• Develop and implement financial policies, internal controls, and standard operating procedures to improve accuracy, consistency, and operational efficiency
• Manage accounts payable reporting, vendor onboarding, and contract tracking to ensure timely payments and visibility into financial obligations
• Maintain accurate financial records and support improvements to the general ledger, chart of accounts, and accounting workflows
• Provide weekly visibility into cash balances, receivables, payables, and collection trends to support cash forecasting and financial planning
• Own and optimize financial systems and integrations, including QuickBooks, Rippling, Ramp, Lithic, and Salesforce-related workflows
• Support audit preparation, tax compliance, financial diligence, and other strategic finance initiatives as the organization grows

Requirements

• 4–6+ years of experience in accounting, finance operations, or a related field, including hands-on experience managing or owning the monthly close process
• Strong background in accounts receivable, invoicing, collections, and cash reconciliation, including demonstrated ability to improve collection performance and reduce DSO
• Experience overseeing outsourced accounting firms, bookkeepers, or other third-party financial service providers
• Hands-on experience administering payroll through Rippling or a comparable platform such as ADP or Gusto
• Proficiency with QuickBooks and Ramp or similar accounting and spend management platforms
• Experience developing and implementing accounting policies, internal controls, and standard operating procedures
• Strong Excel skills, with the ability to analyze, reconcile, and interpret financial data across multiple systems
• Excellent organizational skills and attention to detail, with the ability to manage competing priorities and consistently meet deadlines
• Strong communication and cross-functional collaboration skills, with confidence to drive accountability across internal teams and external partners
• Proactive, process-oriented mindset with the ability to identify inefficiencies, solve problems independently, and build scalable solutions
• Comfortable working in a growing company where processes are evolving and there is an opportunity to help shape how the finance function operates

Preferred Qualifications

• CPA certification
• Experience in healthcare, medical billing, or payer reimbursement operations
• Familiarity with Salesforce and finance-related integrations
• Experience supporting financial audits, fundraising diligence, or accounting operations at a high-growth startup
• Experience working alongside a Controller or helping establish a more structured accounting function

Compensation & Benefits

• Base salary range: $110,000 - $140,000
• Individual compensation will depend on qualifications, skills, experience, location, and applicable laws
• In addition to base salary, the role is eligible to participate in an equity incentive and competitive benefits plans

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