Patient Accounting Manager Jobs in Rochester, NY

Job Description: Get to Know Rivia Mind At Rivia Mind, we believe great mental health care begins with a human connection. Where We Are: We are a psychiatrist-owned mental health practice rooted in New York City, serving individuals across New York, New Jersey, Connecticut, Florida, and Massachusetts through both virtual and hybrid appointments. How We Support: With a Whole-Person Lens, we provide compassionate, science-based care that honors the full complexity of a person's biology, psychology, and life circumstances. We go beyond symptom management with an interdisciplinary care model grounded in collaboration, personalization, and delivered with warmth, respect, and clinical integrity. We bring a high-touch, human-centered approach to every aspect of care, from clinical treatment to operational coordination. Click Here to learn more about our services. Thrive Together: ???? Our shared North Star unites us to provide the best patient experience. At Rivia Mind, we cultivate a collegial culture rooted in:A foundation of shared values and reciprocal supportA mindset of curiosity, learning, and growthA spirit of warmth, openness, and authentic connection Together, we turn challenges into opportunities, and every team member helps shape the future of care at Rivia Mind. Job SummaryThe Accounting Manager will lead Rivia Mind's day-to-day accounting operations and financial reporting as we continue scaling our multi-state mental health practice. Reporting directly to executive leadership and supervising an Accounting Coordinator, you will oversee all core accounting functions—including general ledger management, a timely month-end close, AP/AR, revenue cycle reconciliations, provider payouts, and tax compliance.Beyond operational accounting, you will play a key analytical role by driving monthly departmental budget-vs-actual variance reporting and leading the annual budgeting process in partnership with the CEO and executive leadership. The ideal candidate blends rock-solid GAAP accounting and healthcare/RCM literacy with a tech-forward mindset focused on process automation, data integrity, and cross-functional leadership in a fast-paced, remote environment.Application Window: Until August 17th, 2026Anticipated Start Date: End of September to early October 2026. # of Openings: 1 Job Responsibilities & Qualifications Responsibilities Core Accounting & Month-End CloseManage Cash Flow & Banking Activity: Monitor organizational cash flow, banking activity, expected deposits, vendor payments, payroll funding, and other cash requirements to support sound financial decision-making.Ensure revenue, contractual adjustments, refunds, write-offs, and related receivables are recorded accurately and consistently in accordance with company policy and US GAAP.Manage Month-End Close & GL: Oversee the month-end, quarterly, and annual accounting close processes in accordance with US GAAP, ensuring accurate general ledger management, bank reconciliations, and timely posting of financial data.Prepare and review monthly financial statements, including the income statement, balance sheet, and cash-flow reporting, along with supporting schedules and management commentary.Oversight of AP, Payroll & Payouts: Supervise day-to-day accounts payable, corporate credit card programs, and expense management; collaborate with People Ops to ensure seamless payroll posting and provider payout accuracy.Review and reconcile provider compensation and payout calculations, including productivity-based payments, bonuses, corrections, and related payroll or contractor reporting, in partnership with People Ops and clinical operations.Support multi-state accounting and compliance requirements, including coordination of state filings, payroll-related accounting reconciliations, and other jurisdiction-specific financial obligations, as applicable.Vendor Tax Reporting: Oversee vendor tax compliance by maintaining W-9 documentation, validating vendor tax information, preparing and issuing annual Forms 1099, and coordinating any required tax reporting with external partners.Compliance & Tax Support: Maintain accounting policies and internal controls; coordinate with external CPA/tax partners for annual filings, tax documentation, and regulatory compliance. Financial Planning & Budget SupportDepartmental Budgeting & Variance Analysis: Partner with executive leadership to facilitate the annual budgeting process; own the monthly Budget vs. Actuals reporting to help department heads track spending and manage variances.Reporting & KPI Dashboards: Develop and maintain meaningful financial reporting dashboards (using QuickBooks integrations or reporting software) to provide leadership with clear visibility into cost structures and financial performance.Financial Modeling: Build financial models for new models, services, or hires, as needed, and include appropriate forecasting and reforecasting of costs associated with projects. Healthcare Operations & Systems OptimizationMaintain Accounting for Provider Compensation: Ensure accurate accounting for provider compensation, productivity-based payments/reimbursements, and related accruals in accordance with company policies.Revenue Cycle Financial Reconciliation: Review revenue cycle activity and reconcile insurance reimbursements, clearinghouse deposits, merchant fees, and related revenue transactions to the general ledger. Partner with the RCM team to investigate discrepancies and ensure the accuracy and completeness of financial reporting.Process & Tech Optimization: Continuously evaluate financial workflows and technology stack to automate manual processes, eliminate unnecessary spreadsheet reliance, mitigate risk, and reduce month-end close timelines.Establish and strengthen scalable internal controls, approval workflows, documentation standards, and segregation-of-duties practices appropriate for a growing organization.Coordinate annual financial reviews, audits, due diligence requests, and other external examinations by preparing schedules, documentation, and account support. Team Leadership & CollaborationManage & Mentor Accounting Coordinator: Directly manage, support, and evaluate the accounting coordinator, providing coaching, goal development, and performance feedback to foster professional growth.Cross-Functional Partner: Serve as a collaborative finance partner to leaders across clinical, people operations, and administrative departments to support business expansion and operational planning.Support the financial review of vendor agreements, service contracts, expansion opportunities, and other operational commitments. QualificationsEducation & CertificationEducation: Bachelor's degree in Accounting, Finance, or a related business field (Required).Certifications: CPA, CMA, or active pursuit of certification is preferred, but not required. Experience & Background5+ Years of Accounting Experience: Proven track record in progressive operational accounting, general ledger management, and month-end close procedures within a fast-paced environment.Accounting & Financial Stewardship: Expertise in applying US GAAP and accrual accounting principles to maintain financial integrity through accurate financial reporting, reconciliations, internal controls, and compliance.Healthcare Industry Knowledge: Experience in healthcare, behavioral health, or multi-site clinical operations is strongly preferred (understanding of medical billing, insurance reimbursement cycles, clearinghouses, and EHR integration).Remote & High-Growth Operations: Demonstrated success working autonomously and cross-functionally in a distributed/remote team environment.(A Plus) Leadership Experience: Experience supervising, mentoring, or developing accounting professionals while effectively prioritizing work and managing competing deadlines. Technical & Analytical SkillsQuickBooks Proficiency: Advanced proficiency in QuickBooks Online and its ecosystem of bank/credit card feed integrations.Advanced Data & Spreadsheet Skills: High proficiency in Google Sheets/Excel (Pivot Tables, XLOOKUP/INDEX MATCH, data mapping, and financial modeling) with a drive to automate manual reporting where possible.FP&A & Budgeting Literacy: Experience assisting with annual organizational budgets, tracking departmental spending, and preparing Budget vs. Actual variance reports for leadership.Tech-Forward Aptitude: Comfort navigating modern business platforms (e.g., Google Workspace, project management software like Monday.com, and EHR platforms). Key Attributes & MindsetAnalytical & Detail-Oriented: Exceptional accuracy in reconciliations and record-keeping with a proactive approach to identifying data discrepancies.Process Improver: Continuously seeks ways to optimize month-end workflows, shorten close timelines, and strengthen internal controls.Financial Communication: Ability to translate complex financial information into clear, actionable insights for non-finance stakeholders while maintaining confidentiality. Benefits Benefits That Support You, Personally and Professionally At Rivia Mind, we know that providing exceptional care starts with caring for our team. That's why we offer a comprehensive, thoughtfully designed benefits package that supports your health, financial wellness, growth, and overall well-being—so you can thrive in work and life. Learn more here.3 weeks of front-loaded PTO + 9 paid holidaysAnnual office closure (Dec 25–Jan 1)Annual Impact Days for volunteering or professional development401(k) with employer matchReferral bonus potentialAnnual Continuing Education (CE) Stipend + Flexible Benefit ReimbursementMedical, dental, and vision insurance — with EAP and additional wellness programsVoluntary benefits, HSA, DCA, FSA (based on plan), transit & parking optionsBereavement leave (including pet bereavement) We're a community of clinicians and care-minded professionals who believe in sustainable practice, personal growth, and compassionate support. Come thrive with us. Compensation & Employment Details Pay Range: $107,100 - $140,000, based on Location, Years of Experience, Certification, etc. Pay Type: Salary Discretionary Bonus Terms: Up to 15% bonus potential annually beginning in 2027 Department: FinanceSupervisor: CEOSupervisees: Accounting CoordinatorEmployment Status: Full Time Exemption Status: Exempt W-2Work Environment: Remote ​​Work Schedule: This role follows Eastern Time business hours, Monday to Friday, with the flexibility to choose a consistent schedule of 8:00 AM–4:00 PM, 9:00 AM–5:00 PM, or 10:00 AM–6:00 PM, based on what works best for you and the role's needs. Compensation Determination: The pay range listed reflects the minimum and maximum base salary for this role, determined through an internal compensation assessment that considers similar labor markets to our practice across the United States. Actual compensation is influenced by compensable factors such as location, role responsibilities, required skills, relevant experience, qualifications, role level, and applicable credentials. It is uncommon for an individual to be hired at or near the top of the posted range. In addition to base salary, total compensation may include bonuses, commissions, or other incentives depending on the role. Location Eligibility: At this time, we are only able to consider applicants whose primary residence is in one of the following states within the United States of America: Connecticut, Florida, Massachusetts, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Texas. Because this is not a solely on-site role, your primary residence must remain in one of these approved states. Please note that residing outside of these states—even temporarily—may result in employment eligibility issues, tax implications, or other regulatory concerns. If your location changes or you're based elsewhere, we encourage you to stay connected for future openings. Equal Opportunity Employer: Rivia Mind is an Equal Employment Opportunity Employer. It is the policy of Rivia Mind to provide equal employment opportunities without regard to race, color, ancestry, religion, sex, gender identity or expression, pregnancy, age, ethnic or national origin, immigration or citizenship status, hair, weight, height, disability, marital status, veteran status, sexual orientation, genetic information/GINA, political affiliation or activity, or any other protected characteristic under applicable law. It is also the policy of Rivia Mind that qualified individuals with disabilities receive equal opportunity regarding job application procedures, hiring, and all aspects of the employment process. Rivia Mind is committed to the full inclusion of all qualified individuals. Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of Rivia Mind to provide reasonable accommodations when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, pre-employment testing, to otherwise participate in the selection process, to perform the essential job functions, and/or to receive other benefits and privileges of employment, please contact us directly. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Rivia Mind participates in E-Verify to confirm the identity and employment eligibility of newly hired employees. Right to Work Poster, and E-Verify Poster Applicants must be authorized to work in the United States. We are unable to sponsor work visas at this time. This is in accordance with applicable federal, state, and local laws, including Title VII of the Civil Rights Act, the Americans with Disabilities Act, the Age Discrimination in Employment Act, and the Genetic Information Nondiscrimination Act. If you need assistance or accommodation due to a disability during the application process, please contact our Talent Acquisition team at talentacquisition@riviamind.com.