Finance Operations Associate (Bookkeeping, Billing & Reconciliation)

Location / Employment Details

• Location: Fully remote


• Schedule: Part-time, 20 hours per week to start, with a clear path to full-time as the role grows


• Hours: Mostly asynchronous, with a daily overlap window during U.S. Central Time mornings for questions and updates. No graveyard shift required.


• Reports to: The company's finance lead, working closely with company leadership


• Tools: QuickBooks Online, Google Workspace, and a secure company-provided work browser

About the Company

We are a rapidly growing U.S.-based healthcare services company that gives employers and their teams fast access to some of the country's top orthopedic and musculoskeletal specialists. Founded by a physician with decades of clinical practice, we deliver expert second opinions and care recommendations in days or weeks instead of months.

Our model helps patients avoid unnecessary surgeries and get back to work sooner, while helping employers bring down one of their largest healthcare costs. We work with self-funded employers, benefits brokers, and third-party administrators across the U.S. The team is remote and digital-first, and we already work with talent in the Philippines.

About the Role

Our client volume has grown fast, and our transaction volume has grown with it. Leadership has been keeping the books current on nights and weekends, and that is no longer sustainable. More importantly, we need clean, current financials so we can see profitability quickly and make decisions with confidence.

This role takes ownership of day-to-day financial operations: keeping QuickBooks accurate and reconciled, sending and following up on invoices, and matching incoming payments to individual cases. That frees our finance lead to focus on higher-level planning and analysis.

The role starts at 20 hours per week. If you do the work well and want more, there is more to take on, and the role is designed to grow into a full-time finance operations position.

Key Responsibilities

Bookkeeping & Month-End

• Record and categorize all transactions in QuickBooks Online on a daily or weekly cadence


• Reconcile bank and credit card accounts monthly, and resolve discrepancies quickly


• Keep the chart of accounts clean and consistent so reports are reliable


• Support month-end close alongside the finance lead, including accruals and adjusting entries as directed


• Prepare a monthly P&L and balance sheet, and flag unusual variances

Billing & Accounts Receivable

• Prepare and send client invoices accurately and on schedule


• Track open invoices and send payment reminders and follow-ups


• Maintain an up-to-date AR aging report and escalate overdue accounts


• Answer routine billing questions from client contacts by email

Case Payment Reconciliation

• Match incoming payments to individual case records to confirm what has and hasn't been paid


• Investigate and resolve unmatched, short, or duplicate payments


• Maintain a clear reconciliation log that leadership can review at any time


• Handle all patient-related information under HIPAA standards and company data-security protocols

Accounts Payable & Records

• Enter vendor bills and schedule payments for approval


• Collect and organize vendor documentation, including W-9s, to support year-end 1099 preparation


• Keep supporting documents organized and easy to find

Reporting & Process

• Send leadership a short weekly snapshot of cash, open receivables, and anything that needs attention


• Document recurring processes as written SOPs


• Suggest ways to reduce manual work, such as bank rules, templates, and automation

Required Qualifications

• 3+ years of bookkeeping experience for U.S.-based companies


• Daily, hands-on experience with QuickBooks Online


• Proven experience with bank and credit card reconciliations and supporting month-end close


• Experience creating invoices and following up on unpaid receivables


• Strong attention to detail with high-volume, record-level matching


• Clear written English for invoices, payment follow-ups, and weekly updates


• Proven ability to handle confidential financial and personal data responsibly


• Availability for a daily overlap window during U.S. Central Time mornings

Preferred Qualifications

• Experience in a healthcare BPO or other HIPAA-regulated environment


• Bookkeeping for a healthcare services or professional services company


• QuickBooks Online ProAdvisor certification


• Strong Excel or Google Sheets skills for reconciliation (XLOOKUP, pivot tables)


• Experience with Rippling, Bill.com, or similar payroll and payables tools


• Experience supporting a small, fast-growing company without established SOPs


• Degree in accounting, finance, or a related field

Ideal Candidate Profile

You are:

• A QuickBooks expert who takes pride in books that are clean, current, and reconciled


• The person who notices when a payment doesn't match and keeps digging until it does


• Proactive about receivables. You follow up on an overdue invoice before anyone asks.


• Comfortable working independently and asynchronously, with short, clear updates


• Happy to pick up adjacent back-office work and learn new systems quickly


• Discreet and disciplined with sensitive data

Why Join Us

• Real ownership. You'll own the financial engine of a growing company, and your work goes straight into leadership decisions.


• Room to grow. The role starts part-time and is built to expand into a full-time finance operations position.


• Meaningful work. Our service helps people avoid unnecessary surgery and get back to their lives faster.