Technical Accounting Manager

Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape.

Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools.

Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams.

Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey.

Reporting to our Controller, we're looking for a Technical Accounting Manager to strengthen and scale Pivotal's technical accounting function.

This is a hands-on role for someone who enjoys solving complex accounting challenges, thrives on precision, and takes pride in building well-controlled financial processes. You'll own key areas of our month-end close, help prepare the company for its financial audit, and ensure our accounting practices scale alongside the business.

You'll partner closely with our accounting team, providing technical accounting guidance while helping build the processes, documentation, and controls that create a best-in-class finance organization.

• Own Technical Accounting & Financial Reporting: Take ownership of Pivotal's most complex accounting areas, including stock-based compensation, equity accounting, lease accounting, and other technical accounting matters. Research accounting guidance, prepare supporting documentation, correlating memos, and ensure our accounting practices remain accurate, audit-ready, and scalable as the business grows.
  

• Lead Audit Readiness: Partner with our Controller to prepare Pivotal for annual financial audits. Own audit schedules, support external auditors, document accounting policies and internal controls, and ensure reconciliations and supporting documentation are complete and audit-ready.
  

• Partner Across the Business: Serve as a trusted partner to Operations, Sales, and FP&A on invoicing, commissions, reconciliations, and reporting. Coordinate directly with cross-functional teams to resolve discrepancies and improve clarity.
  

• Strengthen the Close Process: Improve the quality and predictability of our month-end close by building robust reconciliations, documentation, checklists, and review processes that increase accuracy while reducing risk.improvements to ensure the system supports scale.
  

• Build Scalable Accounting Processes: Develop accounting policies, process documentation, and internal controls that support a growing organization. Continuously identify opportunities to improve efficiency, strengthen governance, and prepare the business for future scale.
  

• Partner Across Finance: Work closely with the broader Accounting and Finance teams to review reconciliations, improve accounting workflows, mentor junior team members, and elevate the overall quality of our financial operations.

• 7+ years of progressive accounting experience, including 2+ years in external audit at a public accounting firm (Big Four preferred, but not required)

• CPA required

• Bachelor’s degree in Accounting or equivalent hands-on accounting experience with demonstrated mastery of core principles

• Strong understanding of US GAAP and technical accounting principles

• Experience preparing financial statements, footnotes, and disclosures for private companies.

• Experience supporting or leading external financial audits.

• Experience owning complex balance sheet reconciliations and month-end close.

• Advanced Excel skills

• Experienced in monthly close and balance sheet reconciliations

• Comfortable working with high volumes of transactional data

• Able to communicate clearly with both financial and non-financial stakeholders

• Big Four or recognized regional public accounting experience

• Experience in a high-growth SaaS or venture-backed company

• ERP implementation or financial systems optimization

• Experience with stock-based compensation and equity accounting

We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description.

If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you.

Benefits Include:

• Competitive compensation, including equity

• Full health, dental, and vision coverage

• Retirement savings plan through 401(k)

• Flexible time off

• Opportunities for company-wide connection and events

Ready to Make an Impact?
We’re building something meaningful; and we want you on the team.

Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together.

Work Authorization

Candidates must be authorized to work in the United States without current or future employer sponsorship.

Equal Employment Opportunity

Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.

Reasonable Accommodations

Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know.

Background Checks

Employment is contingent upon successful completion of applicable background checks, where permitted by law.

At-Will Employment

Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.