Payroll Specialist

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 Health Tech Companies and by Linked In 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.

• 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 elevate 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.

• 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…