Staff Accountant - XRHealth America Inc.

Staff Accountant

XRHealth America Inc.

Location: Needham, MA

Employment Type: Full-Time | Hybrid (minimum 3 days per week in the Needham office)

About XRHealth

XRHealth is a Boston-based digital health company pioneering extended reality (XR) therapeutics. We provide FDA-registered, AI-powered virtual reality therapy solutions for physical, cognitive, and behavioral health. Through XRHealth America, our U.S. commercialization business, we operate across several business lines, including accredited DME operations, commercialization, distribution, logistics, and strategic partnerships. We have treated more than 50,000 patients, delivered over one million therapy sessions, and hold partnerships across Medicare, the VA, commercial payers, employers, and health systems.

The Role

XRHealth America is growing rapidly, and we are looking for a hands-on, detail-oriented Staff Accountant to take ownership of day-to-day accounting operations and support the financial infrastructure of our expanding U.S. business.

This is a highly operational role that goes beyond traditional bookkeeping. You will manage core accounting activities while working closely with our Operations, Revenue Cycle Management (RCM), HR, and commercial teams to ensure financial accuracy across purchasing, inventory, product shipments, billing, and revenue.

We are looking for someone who thrives in a fast-paced startup environment, takes initiative, solves problems independently, and is comfortable building and improving processes as the business scales.

The Staff Accountant will be part of the XRHealth America team, reporting to XRHealth America leadership for day-to-day operations, priorities, and execution, while reporting functionally to the Controller within the HQ Finance team for accounting standards, financial reporting, and professional oversight.

Key Responsibilities

Accounting Operations and Financial Close

• Own day-to-day accounting activities, including accounts payable, accounts receivable, cash management, journal entries, accruals, and prepaid expenses.
• Manage the monthly close process, including bank reconciliations, balance sheet reconciliations, and variance analysis.
• Monitor daily cash activity, apply payments, prepare vendor payment runs, and ensure accurate transaction coding.
• Maintain accurate financial records and ensure transactions are properly recorded in the general ledger.
• Support financial reporting, audits, and continuous improvement of accounting processes.

Accounts Payable Vendors and Expenses

• Manage vendor invoices, approvals, payment processing, and accounts payable aging through Ramp.
• Oversee vendor onboarding, including W-9 collection, banking verification, and supporting documentation.
• Reconcile vendor statements and resolve billing or payment discrepancies.
• Review corporate card transactions, employee reimbursements, and travel expenses for accuracy and policy compliance.

Revenue Billing and Financial Systems

• Reconcile billing activity, accounts receivable, and cash collections between NikoHealth and the general ledger.
• Work closely with the RCM team to investigate and resolve discrepancies between orders, billing, payments, and recorded revenue.
• Maintain the accounting records for supplier purchase orders, contracts, and revenue tracked in HubSpot.
• Prepare and issue invoices to DME suppliers and other B2B partners, monitor accounts receivable aging and collections, and follow up on outstanding balances.
• Reconcile HubSpot financial activity to the general ledger, including deferred revenue where applicable.
• Support the accuracy and integrity of financial data across operational and accounting systems.

Inventory Purchasing and Product Accounting

• Track and reconcile product purchases, inventory, shipments, and cost of goods sold.
• Perform three-way matching of purchase orders, shipment records, and vendor invoices.
• Account for in-transit inventory, freight, duties, fixed assets, and related expenses.
• Partner with Operations and Logistics to resolve inventory discrepancies and support periodic inventory counts.
• Ensure accurate financial tracking of hardware purchases and product-related costs.

Payroll Compliance and Reporting

• Reconcile payroll expenses, employer taxes, benefits, and related accruals from Rippling to the general ledger.
• Track headcount changes and prepare monthly payroll and headcount cost reporting by department.
• Maintain state registration and filing calendars, including annual reports and other entity-level requirements.
• Prepare tax workpapers, fixed asset schedules, depreciation records, and 1099 reporting in coordination with external accounting and tax advisors.
• Support financial controls, documentation, and audit readiness.

Process Improvement and Automation

• Identify opportunities to streamline accounting workflows, reduce manual work, and improve financial accuracy.
• Help implement scalable processes and controls that support rapid business growth.
• Leverage technology, automation, and AI tools to improve efficiency, reconciliation, and reporting.
• Collaborate cross-functionally to improve financial visibility and data consistency across systems.

Requirements

• Bachelor's degree in Accounting, Finance, or a related field.
• 3–5 years of hands-on accounting experience, including accounts payable, reconciliations, and month-end close.
• Strong understanding of general ledger accounting, accruals, and financial reporting.
• Experience with purchase orders, inventory accounting, or cost of goods sold in a product-based business.
• Experience working in a multi-entity environment, with the ability to maintain accurate and separate accounting records.
• Strong Excel skills and confidence working with financial data across multiple systems.
• Highly organized, detail-oriented, and able to manage multiple priorities and deadlines.
• Proactive problem-solver who takes ownership and follows through without requiring constant supervision.
• Comfortable working in a fast-moving, evolving startup environment.
• Strong communication skills and ability to collaborate across departments.

·      Ability to work from the Needham, MA office a minimum of three days per week.

Preferred Qualifications

• Experience with NetSuite, Ramp, Rippling, HubSpot, or similar financial and operational systems.
• Experience in healthcare, medical devices, DME, or another regulated industry.
• Familiarity with healthcare billing, revenue cycle management, and accounts receivable reconciliation.
• Experience improving accounting processes through automation and system integrations.

What We Offer

• An opportunity to play a key role in the financial operations of a rapidly growing healthcare technology company.
• Direct ownership and visibility across multiple areas of the business.
• A collaborative, entrepreneurial environment where initiative and problem-solving are valued.
• The opportunity to help build and improve financial processes, systems, and controls as the organization scales.
• A full-time, hybrid position requiring a minimum of three days per week at our Needham, MA office, working closely with leadership and cross-functional teams.

Join XRHealth America and help build the financial foundation supporting the next stage of our growth.