Family Practice Nurse Practitioner Jobs in Las Vegas, NV

About Us

We are a well-established, growing medical and aesthetic practice group in Las Vegas — a plastic surgery practice, med spa, and accredited surgery center under one roof. We are investing in professionalizing our business operations, and this role is a cornerstone of that effort. You’ll join at a moment when systems are being built the right way, with the support of an experienced outside accounting firm.

The Role

You’ll be the on-site hub of our daily financial operations — the reliable, organized person who keeps the day-to-day running while our external fractional accounting team handles the books at a higher level. You’ll work daily with that team and report directly to our CEO.

This is a role for someone who takes real satisfaction in accuracy and routine done well: the cash log that ties out every day, the invoice filed the day it arrives, the payroll data submitted on time, every time.

What You’ll Do

• Oversee daily cash intake using our dual-control procedures, prepare and make daily bank deposits, and maintain the daily cash log
• Produce the daily flash report — a one-screen morning snapshot of yesterday’s collections, cash position, and today’s scheduled activity that leadership runs the day on
• Receive, scan, and code vendor invoices into our AP platform and route them for approval
• Own our purchasing process: serve as the single intake point for purchase requests across the practice, manage vendor relationships and pricing, run the purchase-approval workflow, place orders, and verify deliveries and invoices against orders
• Administer our finance tech stack (AP automation and spend-management card platform) — help roll it out, train staff on it, and keep it running smoothly
• Prepare and submit payroll data each cycle; maintain employee payroll records
• Serve as the on-site point of contact for our external accounting team — pulling documentation, answering questions, and helping the monthly close run smoothly
• Handle vendor calls and manage general office administrative traffic
• Maintain our process library — keep our standard operating procedures organized, current, and in a consistent format as the practice documents how everything gets done (you keep the library; teams write their own procedures)
• Maintain organized digital records for four related business entities
• Support the CEO with administrative and light HR coordination

What We’re Looking For

• 3–5+ years of hands-on bookkeeping or finance-coordinator experience, ideally in a medical/dental practice, surgery center, or another cash-intensive business (retail and restaurant back-office experience translates well)
• Solid working proficiency in QuickBooks
• Strong spreadsheet skills (Excel or Google Sheets) — you can build and maintain a clean, accurate daily report without help, and you write clearly enough to document a procedure someone else can follow
• Working familiarity with accrual accounting concepts (deferrals, prepaids, capitalization) — you don’t need to be an accountant, but you should understand why the books are kept the way they are
• Real payroll processing experience (running the cycle, not just submitting hours)
• Familiarity with AP automation or spend-management tools such as Bill.com, Ramp, or BILL Spend & Expense — or the demonstrated aptitude to learn them fast (we’re implementing these now, and you’ll help drive adoption)
• Genuinely tech-comfortable — you pick up new cloud tools quickly, you’d rather build a system than repeat a manual task, and you’re the person colleagues ask when software misbehaves
• Continuous-improvement mindset — you notice friction and actively look for ways to make every process easier, faster, and more automated. (In this role, improvements to financial processes get proposed and vetted with our external controller before they go live — we want your ideas and our audit trail)
• Meticulous, consistent, and process-driven — you like checklists and you finish them
• Comfortable working within defined procedures and with regular external review of your work — our outside accounting firm reconciles and reviews monthly, and we see that as support, not oversight
• Professional discretion — you’ll work adjacent to confidential patient and financial information
• Steady, friendly presence — staff and vendors will come to you with questions all day

Nice to Have (Not Required)

• Bachelor’s degree, or an associate’s degree in accounting or a bookkeeping certification (e.g., AIPB, NACPB)
• Formal exposure to GAAP / accrual-basis bookkeeping
• Experience setting up or running a purchasing/PO process, or implementing an AP or expense platform
• Medical office manager or medical billing background
• Experience supporting a multi-entity or multi-location business

Important to Know

Because this position handles cash and financial records, our standard hiring process includes a criminal background check, an employment credit check (with your written consent, as permitted under Nevada law), professional reference checks, and coverage under our employee fidelity bond. Candidates with cash-handling experience will recognize these as standard for the role.

You Won’t Be Doing This Alone — and This Isn’t a Dead End

This position is the on-site anchor of a larger finance team. You’ll work every day alongside an external fractional accounting firm — a professional bookkeeper, a controller, and a CFO-level advisor — who handle the higher-level accounting and review the monthly close. In practice, that means:

• Built-in mentorship. You’ll learn accrual accounting, multi-entity finance, and month-end close discipline directly from a controller and CFO — the kind of exposure most bookkeepers never get without going to work at a CPA firm
• A real trajectory. The practice is growing. As we add locations and scale, in-house senior finance roles will emerge — and the person who has mastered this seat, learned from the fractional team, and earned trust with our systems is first in line. This role is designed as the ground floor of our finance function, not the ceiling of yours
• Support, not isolation. When something unusual crosses your desk, you have experienced professionals a message away — you’re never the only person responsible for figuring it out

Why This Role Is a Good Move

• Newly built, clean systems — you’re not inheriting a mess, you’re helping run a well-designed operation from early days
• Stable, profitable, established practice with a long-tenured team
• Direct working relationship with the CEO
• Continuous learning from a professional external accounting team, with a growth path as the practice scales

To apply: Send your résumé and 3–4 sentences about the most cash-intensive or detail-critical role you’ve held to dcollins@smithsurgery.com. Applications reviewed on a rolling basis.

Smith Plastic Surgery is an equal opportunity employer.

Pay: $58,000.00 - $72,000.00 per year

Benefits:

• Dental insurance
• Employee discount
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person