- Job Type: Full-Time
- Function: Accounting/Finance
- Industry: Health Tech
- Post Date: 05/21/2026
- Website: alto.com
- Company Address: 645 Harrison St, Suite 200, San Francisco, California 94107, US
About Alto Pharmacy
Alto is America’s leading digital pharmacy, transforming a $500 billion industry. Founded in 2015, Alto’s better pharmacy model is centered on the critical role of pharmacists as the final link in a person’s health journey.Job Description
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- Remote - North Carolina
Job Summary
We’re seeking a high-impact Senior Accountant.This role owns revenue, accounts receivable, close, reporting, and internal controls for a fast-growing line of business, partnering closely with Operations, Billing, and Finance leadership. You’ll leverage your deep accounting expertise and advanced SAP skills to build scalable processes that meet GAAP standards and healthcare regulations.
We’re seeking a high-impact Senior Accountant.This role owns revenue, accounts receivable, close, reporting, and internal controls for a fast-growing line of business, partnering closely with Operations, Billing, and Finance leadership. You’ll leverage your deep accounting expertise and advanced SAP skills to build scalable processes that meet GAAP standards and healthcare regulations.
Accelerate Your Career as You:
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Prepare and record journal entries related to complex transactions involving equity, debt, leases, internally developed software, intercompany and other areas as needed
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Prepare intercompany journal entries and reconciliations for multiple entities and intercompany transactions
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Prepare monthly general ledger reconciliations
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Assist finance with building out vendor trend analysis and monitor vendor spend by function
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Collaborate with other teams to ensure compliance with internal and external reporting requirements.
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Work independently to investigate GL related inquiries and implement process improvements by working within the accounting team and partnering with cross functional stakeholders.
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Offering guidance and support to junior accounting staff.
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Perform monthly, quarterly and annual analytical procedures to ensure completeness and accuracy of account balances.
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Analyze financial statements and GL data for discrepancies, errors, and other issues that should be brought to the Manager’s attention.
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Assist with research on accounting issues for compliance with generally accepted accounting principles (GAAP) and clearly communicate findings.
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Update company accounting procedures and processes as needed, and follow procedures as implemented
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Strengthen and document internal controls.
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Ad-hoc requests by management.
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Assist with interim and year-end audits, prepare timely and accurate deliverables.
Required Experience & Qualifications
Minimum Qualifications:
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Bachelor’s degree in Accounting or a related field.
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5-7+ years of progressive accounting experience.
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Strong proficiency in US GAAP and accounting for complex transactions.
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Meticulous attention to detail and effective communication skills (verbal and written)
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Strong ability to conduct flux analysis, identify trends and discrepancies, and propose effective solutions.
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Proactive in identifying process inefficiencies and offer suggestions for improvements
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Self-directed, able to perform responsibilities independently with minimal direction
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Proven track record of working with multiple departments to provide financial insights and improve processes.
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Strong desire to be a team player and help in whatever capacity possible.
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Experience with accounting software such as Sage Intacct, NetSuite, Coupa. Advanced skills in Excel, GSuite, and other financial analysis tools.
Preferred Qualifications:
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Experience in public accounting (e.g., Senior Accountant, Senior Auditor) with involvement in GAAP compliance and presenting findings to management is highly desirable.
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Certified Public Accountant (CPA) designation is a plus.
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Industry experience in healthcare is a plus.
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Experience in a fast-paced, high-growth, start-up environment is preferred.
Additional Information
Additional Physical Job Requirements
Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.
Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Alto’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.
Salary and Benefits
Salary Range: $112,000 - $140,000
Commission Eligible: No
Travel: No - Required up to 0% of the time
Location Requirement: Employment at Alto is limited to individuals residing in the following states: Arizona, Arkansas, California, Colorado, Florida, Kansas, Maryland, Missouri, Nevada, New Jersey, New York, North Carolina, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington (WA), and Wisconsin.
Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. At this time, Alto is unable to sponsor or take over sponsorship of an employment Visa.
Benefits: Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&D) insurance, flexible spending account (FSA) and health savings account (HSA), commuter benefits, employer-paid short-term (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 11 paid holidays (seven for Pharmacy and Care team members), and eight weeks of paid parental leave for eligible employees.
Application deadline: June 15, 2026
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Equal Opportunity Employer
Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com.
Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.
Use of Automated Decision Tools
Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us at talent@fuzehealth.com.
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