Senior Accounting Manager

Join a team of brilliant, passionate innovators determined to transform healthcare. At BillionToOne, we've built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. We don't just aim for incremental improvements; we build products that are 10x better than anything that exists today.

Our scientists, engineers, sales executives, and visionaries are united by an unwavering commitment to changing the standard of care in prenatal and cancer diagnostics. This is where cutting-edge science meets human compassion, and every innovation you contribute helps remove the fear of the unknown from some of life's most critical medical moments.

If you're driven by purpose, energized by innovation, and ready to help shape the future of precision medicine at scale, this is where you belong.

The Senior Accounting Manager will oversee the accounting operations of a newly public company in its first full year of SOX 404(b) compliance, including managing the month-end close process, owning the integrity of the general ledger, and serving as a named control owner within our SOX framework. Reporting to the Director of Accounting, this role leads a team of GL and AP accountants, acts as a primary day-to-day contact for our external auditors, and is accountable for the monthly management reporting package including flux analysis and cost-per-test economics.  The ideal candidate has experience in a fast-paced, post-IPO environment and brings the experience and knowledge to drive operational and process improvements.

• →Month-End Close: Manage the month-end and quarter-end close on a dependency-gated calendar in FloQast, including the journal entry control log, reconciliation sign-offs, and close checklist completion driving continuous compression of the close timeline while raising quality and audit-readiness.
• →General Ledger Oversight: Own the accuracy and integrity of the general ledger in NetSuite, including review of recurring and non-standard journal entries, balance sheet reconciliations across the full account population, and root-cause resolution of posting and configuration issues.
• →Internal Controls (SOX 404(b)): Serve as a named owner and reviewer for financial reporting, GL, and close-cycle controls. Maintain control narratives and supporting documentation, ensure IPE (information produced by the entity) meets completeness and accuracy standards, and remediate deficiencies with urgency.  Coordinate submission of deliverables with key business partners.
• →Audit & Compliance: Act as a day-to-day point of contact for our Big 4 external auditor and consulting advisors, managing PBC requests, walkthrough support, sample pulls, and interim and year-end fieldwork.
• →Financial Reporting & Flux Analysis: Own the monthly management reporting package: month-over-month flux analysis by functional area (COGS, R&D, S&M, G&A), cost-per-test analytics for the prenatal and oncology products, and a management summary suitable for the CFO and leadership team.
• →Team Leadership: Lead, mentor, and develop a team of GL and AP accountants spanning general ledger, fixed assets, accounts payable, and payroll, setting clear expectations, building review discipline into every deliverable, and growing the team’s technical depth as the company scales.
• →Technical Accounting: Operationalize technical accounting conclusions in areas including ASC 842 lease accounting including embedded lease assessment, ASC 730 R&D cost treatment, and self-funded health plan IBNR reserves.
• →Process Improvement: Drive improvements to the close and accounting processes bringing both increased speed & efficiency and demonstrated operational compliance.
• →Procure-to-Pay Controls: Provide senior oversight of the vendor master and disbursement control environment, partnering with the Supply Chain team to provide support and governance of procurement across the AP and payment cycle.

• 8-10+ years of progressive accounting experience, including 3+ years managing the close and leading a team of direct reports; post-IPO experience strongly preferred.  Experience in life sciences, diagnostics, or another high-growth regulated industry is a plus.
• CPA required with deep US GAAP fluency.  Big 4 or national audit firm experience is a plus.
• Hands-on SOX 404(b) experience as a control owner including familiarity with control narratives in functional areas outside accounting & reporting , IPE requirements, and deficiency remediation.
• Strong NetSuite experience required, with the ability to query the system directly (saved searches, and ideally SuiteQL), FloQast, Expensify, and Workiva experience are pluses.
• Advanced Excel and analytical abilities.
• Excellent communication and interpersonal skills, with the ability to collaborate effectively across departments.
• Bachelor’s degree in Accounting, Finance, or a related field.

Unity Complete™ is the only non-invasive prenatal screen capable of assessing fetal risk for both common recessive conditions and aneuploidies from a single maternal blood sample.
Unity Confirm™ enables non-invasive confirmation for high-risk screening results through the capture of intact circulating fetal cells using BillionToOne’s Fetal Cell Capture™ Technology.
Our Northstar® liquid biopsy test uniquely combines treatment selection with real-time monitoring, giving oncologists unprecedented precision in cancer care.

From $0 to $400M+ annualized revenue run-rate in just 6 years. In 2025, we completed one of the most successful IPOs for a medical diagnostics company, building on nearly $400M in private funding,including our $130M Series D in 2024 and backed by world-class investors including Hummingbird, Adams Street Partners, Neuberger Berman, Baillie Gifford, and Premji Invest.

Forbes named us one of America's Best Startup Employers for 2025 and we're Great Place to Work certified, with 100% of our people willing to go the extra mile, even as we've scaled to over 700 employees.

Headquartered in Menlo Park with facilities in Union City, CA, and a new lab opening in Austin, TX in 2027, we're continuing to push the boundaries of what's possible in molecular diagnostics. We're just getting started.

Ready to help us change the world, one molecule at a time? Learn more at billiontoone.com