Senior Accountant

Optima Dermatology • Portsmouth, NH

3h

About The Position

We are seeking an experienced Senior Accountant to support complex healthcare accounting functions across our growing dermatology platform. This role will be responsible for healthcare revenue recognition, provider compensation calculations, lease accounting, fixed assets, and payroll accounting. The Senior Accountant will partner closely with clinical operations, revenue cycle, payroll, and finance leadership to ensure accurate financial reporting, compliance with U.S. GAAP, and strong internal controls across multiple medical entities.

Requirements

• Bachelor’s degree in accounting, Finance, or related field
• 5+ years of progressive accounting experience, preferably in healthcare or multi-entity environments
• Strong understanding of U.S. GAAP, including healthcare revenue recognition and ASC 842
• Experience with provider compensation or collections-based compensation models
• Payroll accounting experience required
• Proficiency with ERP/accounting systems such as Sage Intacct, NetSuite, SAP, or similar
• Advanced Excel skills
• Strong organizational, analytical, and communication skills

Nice To Haves

• Experience in medical practice management, physician services, or healthcare platforms
• Familiarity with revenue cycle operations and payer dynamics
• Process improvement or Lean/Six Sigma experience
• Experience supporting audits in a healthcare environment

Responsibilities

• Prepare and review monthly revenue recognition related to professional medical services in accordance with U.S. GAAP
• Reconcile revenue between practice management systems, billing platforms, and the general ledger
• Analyze payer mix, collections, adjustments, and contractual allowances in coordination with revenue cycle teams
• Support audit, compliance, and regulatory requests related to healthcare revenue recognition
• Calculate and record bi-weekly and monthly provider compensation, including collections-based, and incentive compensation models
• Reconcile provider compensation accruals to payroll and payments
• Maintain detailed schedules supporting provider compensation
• Partner with operations, payroll, and HR to ensure accurate and timely provider payments
• Maintain lease schedules for medical offices, surgical suites, and clinical space in accordance with ASC 842
• Record and reconcile right-of-use assets and lease liabilities
• Support new site onboarding, lease modifications, renewals, and terminations
• Prepare audit-ready documentation and disclosures related to lease accounting
• Maintain fixed asset records for medical equipment, leasehold improvements, and IT assets
• Ensure proper capitalization, depreciation, and disposal in accordance with company policy
• Reconcile fixed asset subledger to the general ledger monthly
• Support physical inventory tracking and audit requests related to medical equipment
• Record payroll journal entries and related accruals, including wages, benefits, bonuses, and payroll taxes
• Reconcile payroll-related balance sheet accounts
• Partner with payroll and HR teams to resolve discrepancies
• Support payroll audits and compliance requirements
• Prepare and review journal entries, account reconciliations, and supporting schedules for assigned healthcare entities
• Ensure timely and accurate month-end close
• Assist with financial statement preparation, variance analysis, and management reporting
• Support internal and external audits, including preparation of PBC schedules
• Identify opportunities to improve accounting processes, documentation, and internal controls in a healthcare environment
• Support system integrations between clinical, billing, payroll, and ERP systems
• Maintain audit-ready documentation and compliance support

Benefits

• Competitive salary and performance-based incentives
• Comprehensive benefits package including health, dental, vision, disability, and life insurance
• 401(k) with company match
• PTO and paid holidays
• A collaborative, mission-driven healthcare environment supporting work/life balance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level