Technical Accounting Manager

About Pivotal Health

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…