Senior Accountant

Five Star Home Health Care

$75K — $95K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of accounting experience, ideally in healthcare or Medicare regulation
  • Expertise in managing the monthly close process
  • Strong grounding in balance sheet management and GAAP principles
  • Familiar with allocations, fixed assets, and regulatory contract interpretation
  • Hands-on experience with Sage Intacct accounting software
  • Knowledge of Medicare Cost Reports and reimbursement processes
  • Understanding of payroll regulations specific to Virginia
  • Experience with BPOL filings and local tax requirements
  • Exceptional attention to detail with a focus on audit readiness
  • Bachelor's degree in accounting or finance

Responsibilities

  • Lead the monthly close process, encompassing journal entries and variance analysis
  • Maintain ownership of the balance sheet and ensure compliance and audit preparedness
  • Design and document allocation methodologies suited to current structures
  • Review provider and vendor contracts for compliance and financial implications
  • Prepare and manage fixed asset records accurately
  • Support payroll accounting with reconciliations and labor distribution
  • Understand and implement Virginia payroll compliance in financial processes
  • Assist in the preparation and auditing of Medicare Cost Reports
  • Utilize Sage Intacct for advanced financial reporting and allocations
  • Support various audits and partner with teams for compliant financial reporting

Benefits

  • High-impact role in a regulated healthcare setting
  • Gain exposure to Medicare compliance and reimbursement
  • Chance to strengthen and scale healthcare accounting processes
  • Work within a collaborative, mission-driven leadership team
  • Comprehensive benefits package offered
Full Job Description
We are seeking an experienced Senior Accountant to support a growing healthcare organization. This role requires deep ownership of the monthly close, mastery of the balance sheet, and the ability to interpret payroll data, analyze and troubleshoot complex revenue cycle management processes and healthcare industry regulatory requirements to ensure accurate, compliant reporting.

This position is well suited for a hands-on accountant who understands how accounting decisions impact Medicare Cost Reports, reimbursement, payroll compliance, and audits in a regulated healthcare environment.

Key Responsibilities:
  • Lead and execute the monthly close, including journal entries, accruals, allocations, reconciliations, and variance analysis in a healthcare environment
  • Maintain full ownership of the balance sheet, ensuring all accounts are supported, compliant, and audit-ready
  • Design, document, and apply allocation methodologies consistent with current structure.
  • Review provider, vendor, lease, and payer contracts to identify compliance with requirements of the contract, financial obligations and reimbursement implications
  • Prepare and maintain fixed asset records
  • Support payroll accounting, including accruals, labor distribution and reconciliations
  • Demonstrate a working understanding of Virginia payroll laws and payroll compliance requirements
  • Prepare and support BPOL filings across entities and locations
  • Assist with preparation and audit support of Medicare Cost Reports, including general ledger tie-outs
  • Leverage Sage Intacct for dimensional reporting, allocations, and healthcare financial reporting
  • Support external audits, Medicare audits, and internal compliance reviews
  • Partner with operational, clinical, and leadership teams to ensure compliant financial reporting

Qualifications:
  • 5+ years of progressive accounting experience preferably in a healthcare or Medicare-regulated environment
  • Proven ownership of the monthly close
  • Strong balance sheet expertise with GAAP knowledge
  • Experience with allocations, fixed assets, and contract interpretation in a regulatory setting
  • Hands-on experience with Sage Intacct (preferred)
  • Working knowledge of Medicare Cost Reports and reimbursement concepts
  • Understanding of payroll processing and Virginia payroll laws
  • Experience with BPOL filings and local tax compliance
  • Strong attention to detail and audit-ready documentation skills
  • Bachelor's degree in accounting or finance

Why Join Us:
  • High-impact accounting role in a regulated healthcare environment
  • Exposure to Medicare reporting, reimbursement, and compliance
  • Opportunity to help scale and strengthen healthcare accounting processes
  • Collaborative, mission-driven leadership team
  • Competitive compensation and comprehensive benefit

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