Accounting & Bookkeeping Specialist

Full-Time | Monday – Friday | 8:00 a.m. – 5:00 p.m. Mountain Standard Time (Arizona time)

Location: Remote (South Africa only)

Total Care Connections is one of the largest and fastest-growing home care organizations in Arizona and Colorado. We are seeking a
highly skilled, hands-on Accounting and Bookkeeping Specialist
based in South Africa to support our U.S. operations.

This is a fully remote role for someone who thrives in daily accounting work, understands GAAP at an expert level, and can confidently manage high-volume transaction coding, reconciliations, billing support, and payroll system integration.

You will work closely with our on-site Accounting leadership team in Arizona and support a multi-entity healthcare organization that is scaling quickly. If you love accuracy, ownership, and improving financial systems, this role is for you.

What You'll Do
Daily Accounting and Bookkeeping

• Perform day-to-day accounting and transaction coding in QuickBooks Online with speed and precision.
• Maintain clean, accurate general ledger activity across multiple company entities.
• Complete bank and balance sheet reconciliations regularly to ensure integrity of accounts.
• Record and properly classify incoming payments, deposits, and adjustments.
• Support the Accounting Manager with month-end close tasks and reporting preparation.

Accounts Receivable and Medical Billing Support

• Support accounts receivable oversight, including aging review and reconciliation.
• Work with billing and leadership teams to ensure accurate alignment between billing systems and accounting records.
• Be willing to learn and support U.S. medical billing workflows, including Medicaid and VA claim environments.

Accounts Payable

• Process and reconcile accounts payable using Ramp.
• Ensure vendors are paid accurately and on time, with proper coding and documentation.
• Maintain strong control practices around approvals and expense classification.

Payroll System Integration and Cost Accounting

• Support payroll accounting and system integration, primarily Paychex.
• Help improve payroll cost allocation by location, position, and service line.
• Ensure payroll data flows cleanly into QuickBooks Online for accurate reporting.
• Identify integration gaps and help implement solutions to improve cost visibility.

Reporting Support

• Assist with budget-to-actual reporting and internal financial analysis.
• Help prepare supporting schedules for monthly and quarterly reporting.
• Support cash-to-accrual conversion tasks under direction of leadership.

What Success Looks Like

• QuickBooks Online stays clean, current, and GAAP-aligned with minimal clean-up needed.
• Payroll integration improves so leadership can track labor costs by role, location, and service line accurately.
• Reconciliations are completed on time and discrepancies are resolved quickly.
• Communication is proactive, clear, and reliable across time zones.
• You take ownership of your work and follow through without needing reminders.

Required Qualifications

• Expert-level knowledge of U.S. GAAP.
• Bachelor's degree in Accounting, Finance, or related field required.
• Minimum of 5 years of professional accounting or high-level bookkeeping experience.
• Expert in QuickBooks Online
  , including multi-entity and high-volume environments.
• Strong experience in transaction coding, reconciliations, and general ledger management.
• Experience supporting A/R, A/P, and billing-accounting alignment.
• Proven experience with payroll systems and integration workflows (Paychex experience strongly preferred).
• Advanced Excel skills including pivots, formulas, and lookup functions.
• Healthcare accounting or medical billing exposure strongly preferred.
• Ability to work independently, prioritize effectively, and meet deadlines in a fast-paced setting.
• Excellent attention to detail and high personal accountability.

Communication and Remote Work Requirements

• Excellent English communication skills, written and verbal.
• Reliable high-speed internet and a quiet professional workspace.
• Computer with sufficient processing power for cloud accounting systems.
• Headset and webcam for Zoom, Teams, and internal meetings.
• Backup power and internet plan to ensure continuity of work.
• Ability to work consistently during U.S. Mountain Standard Time business hours.

Why Total Care Connections

We are a mission-driven organization serving seniors, veterans, and individuals with disabilities. We are growing rapidly and building a world-class support team to match the quality of care our frontline caregivers provide.

• This is a chance to work with a strong leadership team, gain deep exposure to U.S. healthcare accounting, and grow with a company that values excellence, initiative, and service.