Position Summary

We are seeking a highly organized and technically strong Senior Accountant to support multiple independent medical clinics on a fractional basis. This role is responsible for maintaining accurate cash-basis financial records, performing detailed reconciliations, preparing monthly financial reporting packages, and ensuring disciplined accounting practices across client entities.

This position reports directly to the CFO and offers meaningful advancement opportunity as the organization continues to scale.

The ideal candidate is a self-starter who works independently with minimal supervision, maintains strong internal documentation, and proactively seeks clarification when encountering unfamiliar transactions or accounting treatment.

Core Responsibilities

General Accounting (QuickBooks Online)

Maintain accurate books for multiple medical clinic entities using QuickBooks Online.
Record cash activity, deposits, expenses, owner draws/distributions, and loan payments.
Manage proper classification of transactions in alignment with chart-of-account standards and adding new GL accounts when appropriate
Maintain consistency across multiple clinic entities.

Bank & Balance Sheet Reconciliations

Perform monthly reconciliations for:

Operating bank accounts (Mercury, Ramp , and other institutions)
Credit cards (Ramp and traditional cards)
Payroll clearing accounts (Rippling)
Loan balances
Other key balance sheet accounts
Maintain reconciliation schedules and supporting documentation.
Identify and resolve discrepancies proactively.

Expense & Systems Integration Oversight

Implement new client Ramp accounts and QBO integration
Monitor Ramp spend management workflows and ensure proper coding.
Review Rippling payroll journal entries and verify accuracy.
Maintain clean documentation trails for audit defensibility.

Financial Reporting

Prepare monthly cash-basis financial statements:
Profit & Loss
Balance Sheet
Executive Summary
Maintain supporting schedules (prepaids, debt, fixed assets, where applicable).
Assist CFO with variance review and ad hoc reporting requests.

Process & Documentation

Maintain standardized file structures and documentation.
Support improvement of accounting workflows.
Assist in establishing repeatable processes across clinic entities.
Escalate unusual transactions or compliance concerns promptly.

Required Qualifications

Bachelor's Degree in Accounting
4+ years of accounting experience (public or industry).
Strong QuickBooks Online proficiency (required).
Experience performing detailed bank and balance sheet reconciliations.
Experience working independently in remote environments.
Strong understanding of cash-basis accounting.
Advanced Excel skills (reconciliation workbooks, pivot tables, structured schedules).
Excellent written communication skills.

Preferred Experience

Experience supporting medical clinics, physician practices, or healthcare entities, but willing to train the right candidate with a strong general accounting background.
Familiarity with:
Ramp (corporate spend management)
Rippling (payroll & HR systems)
Mercury (banking platform)
Experience working with founders, physicians, or small business owners.

Ideal Candidate Profile

Highly detail-oriented and disciplined.
Comfortable owning a month-end process independently.
Structured and organized in documentation.
Confident asking clarifying questions when needed.
Comfortable operating in a growing, process-building environment.
Interested in long-term advancement and increased responsibility.

Advancement Opportunity

This role has a defined path for growth as the organization expands. High performers may advance into:

Accounting Manager/Controller based on Business growth and needs
Client-facing financial advisor role
Expanded hours and compensation as portfolio grows

Compensation

Hourly rate commensurate with experience.
Flexible remote schedule.
Opportunity for expanded hours and compensation over time.

Equal Opportunity Statement

We are an Equal Opportunity Employer and comply with all applicable federal, state, and local employment laws.

Job Duties & Employment Disclaimer

This position description is intended to provide a general overview of the role and its primary responsibilities. It is not intended to be a comprehensive listing of all duties, responsibilities, or activities required of the employee. Duties may change at any time based on organizational needs, client demands, regulatory requirements, or business priorities.

The employee may be required to perform additional duties and responsibilities as assigned, including tasks reasonably related to the position or necessary to support the operational needs of the organization and its clients.

Nothing in this job description or posting constitutes a contract of employment, express or implied, nor does it guarantee any specific duties, hours, compensation structure, advancement opportunity, or continued employment. Employment with MedCBO is at-will to the fullest extent permitted by applicable law, meaning that either the employee or the Company may terminate employment at any time, with or without cause or notice, subject to applicable law.

MedCBO reserves the right to modify job duties, reporting relationships, compensation structures, and operational expectations at its discretion in accordance with applicable federal, state, and local laws.

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