Cadence is the clinical AI company automating the treatment of chronic disease. Its Clinical Intelligence takes on the routine, high-volume work of chronic care – monitoring patients, surfacing risks, and coordinating action – so clinicians can focus on the decisions that require them. Grounded in partnerships with more than 20 leading health systems, deep EMR integrations, dedicated medical group, and experience serving a population of more than 100,000 patients, the system learns from real-world care delivery, improving as it scales. Cadence has been recognized by TIME as one of the Top 100 HealthTech Companies and by LinkedIn as a Top Startup (#4, 2025).
The Payroll Specialist will support accurate, timely US payroll for a growing, multi-state healthcare technology organization. Reporting to the Senior Payroll Manager, you will process multiple pay groups across biweekly and semimonthly cycles and partner closely with Finance, Benefits, and People to maintain reliable payroll operations and a positive employee experience.
This role combines hands-on processing, payroll audits, tax support, and employee service. You will take ownership of recurring workflows, investigate discrepancies, and raise issues early enough to meet payroll deadlines. As the organization grows, you will help strengthen documentation, controls, reporting, and systems so payroll processes can scale with the business.
Payroll Processing & Timekeeping- Process multiple US pay groups across biweekly and semimonthly cycles, completing payroll previews, audits, approval coordination, and funding steps within established deadlines.
- Validate new hires, terminations, compensation and job changes, retroactive pay, bonuses, commissions, and other one-time earnings against approved source records.
- Review payroll results for unexpected changes in earnings, deductions, taxes, and net pay; investigate discrepancies and resolve or escalate exceptions before submission.
- Calculate and process off-cycle and manual payments, including final pay in accordance with applicable state timing requirements.
- Audit timekeeping data for accuracy and completeness; partner with managers and People to resolve missing punches, unapproved time, and exception pay.
- Administer garnishments, child support orders, tax levies, and other court-ordered deductions, maintaining supporting records and coordinating required processing.
- Maintain and audit PTO and leave accruals; coordinate payroll treatment for leaves of absence with People and Benefits.
Payroll Tax, Compliance & Controls
- Support multi-state payroll tax compliance, including state and local jurisdiction registrations, rate updates, and account maintenance.
- Monitor agency notices, research discrepancies, and coordinate resolution with the payroll provider and relevant jurisdictions.
- Support quarter-end and year-end activities, including W-2 preparation, review, reconciliation, and W-2c corrections.
- Maintain working knowledge of federal, state, and local wage and hour requirements relevant to payroll, including FLSA, pay frequency, overtime, final pay, and pay statements.
- Support internal and external audits, including 401(k), workers’ compensation, and financial audits, by assembling documentation and reconciling payroll data.
- Maintain documented procedures, audit trails, and internal controls, including appropriate approval steps and segregation of duties.
- Handle compensation, tax, banking, and employee information with discretion and in accordance with company data-handling procedures.
- Partner with Finance on payroll funding, general ledger mapping, journal entries, and payroll account reconciliation.
- Reconcile benefit deductions with Benefits and carrier invoices; investigate discrepancies, process corrections, and manage arrears.
- Partner with People to maintain employee data integrity and accurate onboarding, offboarding, job, and compensation changes.
- Support 401(k) contribution and loan processing, including funding and census reporting.
- Communicate payroll cutoffs, missing inputs, and unresolved exceptions to relevant partners so dependencies are addressed before deadlines.
- Serve as a responsive point of contact for employee payroll questions, resolving issues with accuracy, professionalism, and discretion.
- Research questions about earnings, deductions, taxes, and payment discrepancies using payroll records and supporting documentation.
- Explain findings and correction timelines clearly, document resolutions, and escalate complex issues to the Senior Payroll Manager or appropriate partner.
- Produce standard and ad hoc payroll reports for Finance, People, and leadership; validate report accuracy and explain material discrepancies.
- Support payroll system configuration testing, upgrades, acquisitions, and implementation projects by validating employee data and payroll results.
- Identify recurring errors and manual work, recommend practical improvements, and support automation as the payroll function scales.
- Keep payroll procedures and checklists current to support consistent execution, coverage, and knowledge sharing.
WHAT YOU’LL NEED:Required Qualifications
- At least five years of hands-on US payroll processing experience, including multi-state payroll.
- Experience processing multiple pay groups and pay frequencies, including biweekly and semimonthly cycles.
- Working knowledge of federal and multi-state wage and hour, payroll tax, and pay practice requirements.
- Demonstrated accuracy and attention to detail, with the ability to prioritize competing tasks and meet firm payroll deadlines.
- Strong analytical and problem-solving skills, including the ability to investigate discrepancies, reconcile records, and document resolutions.
- Proven discretion when handling confidential compensation and employee information.
- Clear written and verbal communication with employees, managers, and cross-functional partners.
- Ability to work independently in a fully remote environment, take ownership of recurring responsibilities, and escalate risks promptly.
- Experience with Rippling.
- Experience supporting state and local payroll tax registrations and account setup.
- Healthcare or other multi-site workforce experience with a substantial hourly employee population.
- Experience supporting payroll through organizational growth, acquisitions, or system implementations.
- Payroll is processed accurately and on time across all assigned pay groups, with required audits and approvals completed before submission.
- Payroll exceptions are identified early, researched thoroughly, and resolved or escalated with clear ownership and follow-through.
- Employee payroll questions receive timely, accurate responses and understandable explanations of corrections.
- Payroll records, benefit deductions, retirement contributions, and Finance reconciliations are consistent and supported by reliable documentation.
- Tax notices, registrations, and quarter-end and year-end activities are tracked and completed in coordination with the Senior Payroll Manager and payroll provider.
- People, Benefits, and Finance partners have clear visibility into deadlines, required inputs, and unresolved issues.
- Procedures, controls, and system improvements reduce recurring errors and support a growing payroll operation.
Benefits & Perks
- Competitive pay & equity*
- Fully remote
- Comprehensive health coverage: Medical, dental & vision
- Paid time off
- 401k plan + matching
- Paid parental leave
- Home office stipend
*benefit offerings may vary depending on job profile, job level and worker type
Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws.
A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team. Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.
If you require a reasonable accommodation during the interview or hiring process, please notify your recruiter.
Skills Required
- At least five years of hands-on US payroll processing experience, including multi-state payroll.
- Experience processing multiple pay groups and pay frequencies, including biweekly and semimonthly cycles.
- Working knowledge of federal and multi-state wage and hour, payroll tax, and pay practice requirements.
- Accuracy and attention to detail, with the ability to prioritize competing tasks and meet firm payroll deadlines.
- Strong analytical and problem-solving skills, including investigating discrepancies, reconciling records, and documenting resolutions.
- Discretion when handling confidential compensation and employee information.
- Clear written and verbal communication with employees, managers, and cross-functional partners.
- Ability to work independently in a fully remote environment, own recurring responsibilities, and escalate risks promptly.
- Experience with Rippling.
- Experience supporting state and local payroll tax registrations and account setup.
- Healthcare or other multi-site workforce experience with a substantial hourly employee population.
- Experience supporting payroll through organizational growth, acquisitions, or system implementations.
Cadence (cadence.care) Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Cadence (cadence.care) and has not been reviewed or approved by Cadence (cadence.care).
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Healthcare Strength — Health, dental, and vision coverage are complemented by mental health support and wellness programs. Offerings such as One Medical access, TalkSpace, and a 24/7 employee assistance program reinforce comprehensive care.
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Leave & Time Off Breadth — Time off includes unlimited vacation, paid holidays, and paid sick days. Parental leave is described as generous.
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Retirement Support — A 401(k) plan with company matching supports long-term savings. Additional tools like HSAs and FSAs bolster overall financial security.
Cadence (cadence.care) Insights
What We Do
Cadence is future-proofing primary care for an aging population. We’re building the first AI-native chronic disease platform – extending the doctor’s office beyond the visit and enabling health systems to deliver proactive care at home. Powered by our care intelligence and multidisciplinary clinical team, we monitor every patient, identify risks early, and act before problems escalate. Today, more than 90,000 seniors across 20 health systems rely on Cadence to stay healthier at home. Every day, more than 7,000 Americans age into Medicare, most with complex, ongoing health needs. Traditional healthcare was built for episodic visits, not for the continuous support that chronic care requires. The result? Overwhelmed health systems, rising costs, and patients who fall through the cracks. Cadence solves this problem. Our platform seamlessly integrates with a health system’s existing clinical workflow, using AI and machine learning to continuously monitor patient data, detect trends, and trigger timely interventions. We pair this technology with a nationally licensed clinical team that collaborates directly with each patient’s physician ensuring that every alert turns into meaningful, compassionate action. This hybrid model of technology + clinical care is what sets Cadence apart. We don’t just collect data; we turn insights into outcomes. Behind our platform is a world-class team of engineers, clinicians, and operators, all united by a shared mission — to make compassionate, continuous care accessible at scale. We tackle big, complex challenges with cutting-edge technology and deep empathy, knowing that every improvement we make has a direct impact on real people’s lives. Together, we’re building a system where technology amplifies humanity — and every patient gets the care they deserve, every day.
Why Work With Us
We’re a collaborative, learning-driven engineering culture tackling one of the toughest problems in tech - healthcare at scale. At Cadence, you’ll ship real-world systems that impact thousands of patients, gain exposure to cutting-edge AI and data science, and grow alongside teammates who value curiosity, humility, and excellence.
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