Senior Accountant – US Bookkeeping & Finance Operations (QBO/Xero)

Senior Accountant – US Bookkeeping & Finance Operations (QBO/Xero)

Full-Time | Remote Currently | Pune, Bengaluru or New Delhi–NCR | ₹13–17 LPA CTC | Evening IST

About Remix Medical

Remix Medical is a physician-owned, US-based multispecialty medical group operating across multiple locations. We are hiring a full-time Senior Accountant to take ownership of our day-to-day accounting and bookkeeping operations from India.

This is an internal position working directly with Remix Medical’s US leadership and external CPA—not a BPO queue or a role divided among multiple unrelated clients.

You will maintain accurate books, manage AP and financial operations through modern cloud-based systems, complete monthly close, prepare management reporting and keep the company ready for tax filings, audits and leadership decisions.

Please Apply Only If

Candidates must meet all of the following requirements:

• At least five years of full-cycle bookkeeping or accounting experience.
• Direct experience supporting US-based businesses.
• Recent, hands-on experience with QuickBooks Online or Xero.
• Hands-on experience with both Ramp and Bill.com.
• Working knowledge of the US tax system and tax-ready bookkeeping requirements.
• Experience completing monthly close and preparing financial statements.
• Strong written and spoken English for direct communication with US stakeholders.
• Current residence in Pune, Bengaluru or New Delhi–NCR.
• Ability to work a consistent evening IST schedule with overlap into US Central Time mornings.
• Compensation expectations within the published ₹13–17 LPA CTC range.

NetSuite experience is not required. Applicants whose experience is limited to data entry, invoice processing or one portion of the accounting cycle are unlikely to be a fit.

About the Role

This is a hands-on individual-contributor position with substantial ownership. You will be responsible for maintaining the accuracy, timeliness and organization of Remix Medical’s accounting records.

You will manage recurring accounting activities independently while working closely with US practice leadership, operational team members and our external CPA. You must be comfortable moving between transaction-level work, monthly close, financial reporting and process improvement.

The right candidate is a strong senior bookkeeper or staff/senior accountant who understands how accurate accounting supports cash management, tax compliance and business decisions.

What You Will Own

General Ledger and Monthly Close

• Maintain an accurate and properly classified general ledger in QuickBooks Online, Xero or the company’s designated cloud accounting platform.
• Maintain the chart of accounts, accounting dimensions, vendors and financial records.
• Record and review journal entries, including accruals, prepayments, depreciation, payroll and correcting entries.
• Complete monthly close according to an established calendar.
• Prepare and maintain monthly balance-sheet reconciliations.
• Investigate unusual balances, duplicate transactions and period-over-period variances.
• Ensure supporting documentation is attached, organized and audit-ready.
• Maintain appropriate accounting records across practice locations, departments or business entities.

Accounts Payable and Bill.com

• Manage accounts payable from invoice receipt through approval and payment.
• Enter, code and route vendor bills through Bill.com.
• Maintain vendor records, payment terms and supporting documentation.
• Monitor approval queues and follow up on delayed approvals.
• Prepare payment runs while maintaining proper authorization and segregation of duties.
• Reconcile Bill.com activity to the general ledger and bank accounts.
• Review vendor statements and resolve missing invoices, duplicate bills and unapplied credits.
• Support vendor onboarding and collect required tax documentation, including Forms W-9 where applicable.
• Maintain organized records for year-end 1099 preparation.

Ramp and Expense Management

• Manage Ramp card and expense-accounting workflows.
• Review card transactions, receipts, expense classifications and approval status.
• Reconcile Ramp activity to the general ledger.
• Follow up promptly on missing receipts or incomplete transaction documentation.
• Maintain cardholder, category, department and spending-control structures.
• Identify duplicate charges, policy exceptions and unusual transactions.
• Improve Ramp rules, coding automation and approval workflows while maintaining appropriate financial controls.

Cash, Banking and Reconciliations

• Complete weekly and monthly reconciliations for bank accounts, credit cards, Ramp, Bill.com and merchant or payment-processing accounts.
• Investigate and resolve unreconciled or duplicated transactions.
• Record transfers, fees, interest, refunds and other banking activity accurately.
• Maintain visibility into operating cash and upcoming payment obligations.
• Assist leadership with short-term cash planning and payment prioritization.
• Ensure reconciliations are completed and reviewed before monthly close is finalized.

Accounts Receivable and Revenue Reconciliation

• Record and reconcile operating receipts and other non-clinical receivables.
• Reconcile deposits and payment-processor settlements to source systems and bank activity.
• Apply receipts and credits accurately.
• Monitor aged business receivables and follow up with responsible stakeholders.
• Coordinate with the revenue-cycle team when accounting records must be reconciled to patient, insurance or practice-management activity.
• Maintain a clear separation between revenue-cycle operational work and general-ledger accounting while ensuring the systems reconcile.

Payroll Accounting

• Record payroll journal entries from US payroll providers.
• Reconcile payroll, benefits, payroll-clearing accounts and related liabilities.
• Review payroll reports for reasonableness and investigate material discrepancies.
• Coordinate with leadership and payroll providers regarding corrections.
• Maintain payroll documentation required for monthly close, CPA review and tax support.
• Experience running payroll is helpful but is not required if the candidate has strong payroll-accounting experience.

Financial Reporting

• Prepare monthly profit-and-loss, balance-sheet and cash-flow statements.
• Produce reporting by location, department, entity or other management category where required.
• Prepare budget-to-actual and period-over-period variance analyses.
• Explain material changes in revenue, expenses, cash, liabilities and working capital.
• Create concise financial reporting packages for US practice leadership.
• Turn ad hoc reporting requests around accurately and promptly.
• Translate accounting data into clear business explanations rather than providing unexplained spreadsheets.
• Support higher-level reporting on cash requirements, spending trends, vendor concentration and operating performance.

US Tax and CPA Coordination

• Maintain tax-ready books and supporting schedules throughout the year.
• Coordinate with the external US CPA on monthly, quarterly and year-end requirements.
• Prepare workpapers and account reconciliations needed for US tax filings.
• Support Forms W-9 collection and Forms 1099-NEC or 1099-MISC preparation.
• Maintain awareness of common federal, state and local tax deadlines affecting business accounting.
• Support sales-and-use-tax, payroll-tax or other tax-related reconciliations where applicable.
• Understand common US entity structures and how bookkeeping requirements may differ among them.
• Identify potential tax-accounting issues and escalate them to the CPA or leadership rather than making unsupported tax decisions.
• Support tax notices, audit requests and CPA questions with complete documentation.

This position does not require the employee to sign tax returns or independently provide legal or tax advice.

Systems and Process Improvement

• Improve workflows within QuickBooks Online or Xero, Ramp and Bill.com.
• Use bank rules, transaction rules, approval workflows and integrations responsibly.
• Identify recurring manual work that can be standardized or automated.
• Evaluate emerging accounting and fintech tools that may improve close speed, controls or management reporting.
• Recommend technology based on measurable value, accuracy, integration quality and security—not novelty alone.
• Document accounting policies, recurring procedures and close checklists.
• Build processes that can support additional providers, locations, entities and transaction volume.

Required Qualifications

• Minimum five years of full-cycle bookkeeping or accounting experience.
• Recent, hands-on experience with at least one of the following:
  • QuickBooks Online
  • Xero
• Hands-on experience with both Ramp and Bill.com.
• Direct accounting experience supporting US-based companies.
• Working knowledge of US GAAP fundamentals.
• Practical knowledge of the US business-tax environment, including tax-ready books, W-9 and 1099 processes, payroll-related liabilities and CPA workpaper support.
• Experience managing general-ledger activity, journal entries, AP, bank and credit-card reconciliations and monthly close.
• Experience preparing profit-and-loss statements, balance sheets and cash-flow reporting.
• Strong Excel or Google Sheets ability, including formulas, lookups, pivot tables, filters and data reconciliation.
• Excellent written and spoken English.
• Ability to communicate directly and proactively with US-based leadership and professional advisors.
• Strong judgment regarding confidential financial, payroll and patient-related information.
• Bachelor’s degree in accounting, commerce, finance or a related field, or equivalent relevant professional experience.
• Current residence in Pune, Bengaluru or New Delhi–NCR.

Employment history and qualifications must be verifiable. Candidates are not expected to disclose information protected by client or employer confidentiality obligations.

Preferred Qualifications

• Experience using emerging accounting or fintech platforms such as Puzzle.io or similar automation-focused tools.
• Experience creating executive dashboards, financial models or high-level management reporting.
• Healthcare, medical-practice, dental or other US healthcare accounting experience.
• Experience reconciling healthcare revenue, patient payments, insurance receipts, refunds or practice-management systems to the general ledger.
• Experience with multisite or multi-entity accounting.
• Experience with US payroll providers such as ADP, Gusto or Paychex.
• Experience with Brex or other cloud-based expense-management platforms.
• Experience integrating accounting, banking, AP, expense and reporting systems.
• Experience cleaning up historical books or improving an inefficient monthly close.
• CA Inter, CMA, CPA, ACCA or a comparable accounting credential.

NetSuite familiarity is welcome but is not required or preferred over strong QuickBooks Online or Xero experience.

What You Will Bring

• High accuracy and disciplined attention to detail.
• Ability to own a recurring close cycle without daily supervision.
• Strong reconciliation and problem-solving skills.
• Clear, proactive communication, including timely status updates and early escalation of problems.
• Comfort operating in a growing organization where processes may evolve.
• Good judgment when balancing automation, efficiency and financial controls.
• Discretion when handling payroll, banking, tax and other confidential information.
• A bias toward correcting root causes rather than repeatedly clearing the same exceptions.

What Success Looks Like

Within the first 90 days, the successful candidate will:

• Gain command of the chart of accounts, recurring transactions and finance systems.
• Establish reliable weekly and monthly reconciliation routines.
• Complete an accurate and timely monthly close.
• Validate Ramp and Bill.com workflows and resolve material exceptions.
• Organize tax and CPA support documentation.
• Produce a consistent monthly financial-reporting package for leadership.
• Identify and begin implementing the highest-value process improvements.

Longer-term success will be measured by:

• Accurate, current and audit-ready books
• Timely monthly close
• Fully reconciled bank, card and financial-platform accounts
• Reliable AP and payment controls
• Complete vendor and tax documentation
• Clear financial reporting and variance explanations
• Fewer manual errors and recurring exceptions
• Improved automation without weakened controls
• Proactive communication with US leadership and the external CPA

Work Arrangement and Schedule

• Full-time employment in India.
• Remote currently.
• Candidate must reside in Pune, Bengaluru or New Delhi–NCR.
• The role may transition to a hybrid or office-based arrangement in the future with reasonable advance notice.
• A consistent evening IST schedule is required to provide daily overlap with US Central Time mornings.
• This is not an overnight-shift position.
• The regular shift and any daylight-saving-time adjustments will be confirmed during the initial screening process.
• The employee must work from a private environment suitable for confidential financial and healthcare information.
• Company-approved equipment and security requirements will apply.

Compensation and Benefits

• ₹13,00,000–₹17,00,000 annual CTC
• Final compensation within this range will be based on:
  • Depth of full-cycle US accounting experience
  • QuickBooks Online or Xero proficiency
  • Ramp and Bill.com experience
  • US tax-system knowledge
  • Monthly-close and reporting ability
  • Healthcare-accounting experience
• Group health insurance for the employee and eligible family members
• Equipment allowance
• Internet and work-from-home stipend
• Performance bonus
• Applicable statutory benefits under Indian law
• Direct working relationship with a US-based medical practice—not a BPO assignment

Applicants should apply only if the published compensation range is compatible with their expectations.

Hiring Process

Shortlisted candidates should expect:

1. Resume and experience review
2. Brief spoken-English and schedule-alignment screen
3. US accounting and systems interview
4. Short, anonymized reconciliation or month-end-close exercise
5. Interview with US practice leadership
6. Employment and reference verification

Candidates will never be asked to access a current or former employer’s financial systems or disclose credentials, bank information, patient information, client-confidential records or proprietary documents.

How to Apply

Submit a current resume that clearly identifies:

• Total years of full-cycle accounting or bookkeeping experience
• Dates and recency of QuickBooks Online or Xero experience
• Specific Ramp and Bill.com responsibilities
• US companies or business types supported
• Monthly-close and financial-reporting responsibilities
• US tax and CPA-coordination experience
• Healthcare-accounting experience, if applicable
• Current location
• Notice period

Generic resumes that do not clearly establish QuickBooks Online or Xero experience, Ramp and Bill.com proficiency and direct US accounting experience are unlikely to be shortlisted.

Equal Opportunity

Remix Medical evaluates applicants based on job-related qualifications, experience, performance and ability to fulfill the responsibilities of the position. We welcome qualified candidates from all backgrounds.