Senior Accountant

Midi Health is seeking a hands-on Senior Accountant with strong inventory and cost accounting experience to support core accounting operations in a fast-growing, venture-backed healthcare and technology environment. This role is critical to maintaining accurate financials, strengthening close processes, and supporting compliance across revenue, payroll, and sales tax as the company scales.

This is a high-impact, hands-on role requiring a proactive approach. The Senior Accountant must be able to own areas end-to-end, identify issues before they become problems, and operate effectively in a dynamic, evolving environment..

This role will own and manage inventory-related accounting, including:

• Maintain accurate inventory records across raw materials, WIP (if applicable), and finished goods.
• Ensure proper inventory valuation in accordance with GAAP.
• Record and reconcile inventory purchases, usage, write-offs, obsolescence, and adjustments.
• Calculate and reconcile COGS, including pharmacy and supplement-related product costs, freight, and other landed costs.
• Perform monthly inventory roll-forwards and tie-outs to the general ledger.
• Partner closely with Operations and Supply Chain to investigate and resolve complex inventory variances.

• Own key areas of the monthly close process, including journal entries, reconciliations, and variance analysis.
• Prepare and review balance sheet reconciliations (cash, AR, AP, accrued expenses, payroll, equity).
• Ensure timely, accurate financial reporting in accordance with GAAP.

• Support revenue recognition under ASC 606, including analysis of contracts, reimbursements, and pharmacy-related transactions.
• Lead reconciliation of medical vs. product revenue streams.
• Partner with FP&A and Finance leadership on revenue reporting accuracy.

• Reconcile payroll, benefits, and related accruals across multi-state operations.
• Support stock-based compensation accounting under ASC 718, including monthly expense entries and reconciliations.

• Ensure compliance with state and local sales tax filings and reconciliations (product and healthcare-related taxes).
• Support audits (financial, sales tax, and other compliance reviews).

• Maintain accurate accounting records within the ERP, and leverage system capabilities to identify and resolve process inefficiencies.
• Support implementation of new tools, policies, or accounting standards as needed.

• Support external auditors and consultants.
• Prepare schedules and analyses for leadership, fundraising, and board reporting.
• Collaborate closely with Finance, Operations, Payroll, and Revenue teams.

• Bachelor’s degree in Accounting or Finance, or equivalent.
• 4–7+ years of progressive accounting experience
• Strong knowledge of GAAP; experience with ASC 606 required
• Experience in healthcare, technology, or high-growth environments
• Advanced proficiency in Excel (e.g., pivot tables, VLOOKUP, complex formulas) and experience working with large datasets.
• Experience with NetSuite, Sage Intacct, or similar ERP systems

• CPA or CPA-track
• Experience with multi-entity or multi-state operations
• Prior experience with accounting or tax system implementation or significant migration projects.
• Familiarity with sales tax automation tools (Avalara, Sphere, Anrok, etc.)
• Prior experience in a startup or PE/VC-backed company

• Month-end close runs smoother and faster
• Reconciliations are clean, documented, and review-ready
• Revenue and payroll reporting issues are identified early—not during audits
• Finance leadership trusts your numbers without re-checking them