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HEALTHCARE CAREERS Updated: August 13, 2024

Bookkeeper vs Accountant

Article by Adam Fenster
accounting professional holding a calculator above a binder of financial information

While some people choose careers that involve working directly with patients — such as becoming a dental assistant, medical assistant, or nursing assistant — others prefer to spend their days in a less patient-facing role.

If you fall into the latter category, a career as a bookkeeper or accountant may be right for you because both of these roles offer the opportunity to add, subtract, and average data to your heart’s content.

Sometimes these two titles are used interchangeably, but they are actually very different positions. To help you better understand how they differ, it helps to first recognize what each one is on a foundational level.

Breaking Down Bookkeeping and Accounting Foundationally

A bookkeeper is someone who maintains financial records—or “keeps the books” as it’s often said—for professionals, businesses, and organizations. Put another way, a person in this role is tasked with keeping track of all of the monies coming in (which are often referred to as credits in the accounting world), as well as all of the monies going out (commonly called debits).

An accountant, on the other hand, is a financial professional who prepares a company’s financial documents, analyzes these documents’ data, and may be called upon to audit account information. In some cases, accountants also make recommendations to help the business or businessperson attain and maintain higher levels of profitability.

Both use the same set of numbers, it’s just that the first one (the bookkeeper) compiles all the data and presents it to organizations to use as they see fit, while the second (the accountant) can do more with the information, even offering advice as to how to move forward in a way that helps financially.

Similarities in Both Accounting Roles

Before we dive deeper into the differences between these roles, let’s talk about what they have in common.

Work Environment

Both of these financial professionals work in an office setting. Sometimes these offices are located within an organization or business. Uncommonly, services may be provided out of one’s private office or home.

Each also generally works full-time. The Bureau of Labor Statistics (BLS) further indicates that there may be times when these hours could become extended, such as during tax time or if audits are being conducted.1, 2

The Handling of Confidential Financial Data

Both accounting roles also require the sharing of important financial data. Therefore, regardless of which one you choose as a potential career path, a certain level of discretion is necessary.

There is no federally mandated accountant - client privilege that prevents this type of financial professional from divulging a company’s confidential information to third parties. However, there is at least one federal statute—26. U.S.C. § 7525(a)—that does provide businesses and accounting clients with some level of confidentially.3

Understanding of Financial Statements and Jargon

Working in both bookkeeper and accountant roles also requires some degree of familiarity with financial statements commonly used by businesses. Taking this one step further, you must also know which information goes where on the forms so all the company’s data is reflected accurately in its bottom line.

This requires being familiar with basic accounting jargon and terminology. For instance, when working with a company’s finances, it’s important to know that “appreciation” refers to the increase in an asset’s value while “principal” refers to the face amount of a security minus any premium or interest.

When providing services to organizations within the healthcare field, it’s also important to know about healthcare business operations, medical terminology, the healthcare claim cycle, and claims processing.

Requires Organization and Accuracy

To succeed in either of these roles, you need a high level of organization and a keen attention to detail. If you aren’t organized, you may have a difficult time locating and keeping track of all the necessary information. And if you don’t pay enough attention to detail, the data you provide could be inaccurate, which can create several problems for the business or organization, including:4

  • Exposure to penalties
  • Trouble securing capital
  • Reputation damage

For these reasons, both bookkeepers and accountants must be organized and detail-oriented. If they aren’t, they may be putting their employers, clients, and stockholders at risk.

How Bookkeepers and Accountants Are Different

You may be wondering how each is different. Here are a few areas to consider.

Job Duties, Responsibilities, and Tools

As a bookkeeper, your primary duty is to collect all the business’s financial data and make sure it is recorded accurately. This typically involves using what is called a general ledger, a term used to describe a system of placing all financial information in its appropriate category according to whether it is an asset, liability, revenue, expense, or owner equity.5

The BLS adds that bookkeepers – also sometimes referred to as bookkeeping clerks, accounting clerks, or auditing clerks – often have job duties related to preparing bank deposits, verifying receipts, processing payroll, making purchases, preparing invoices, and monitoring accounts that are overdue.6

Accountants’ duties and tools are quitedifferent. For instance, instead of working so much with a general ledger, accountants work primarily with financial documents or statements. There are three main financial statements used in business to measure a company’s strength. They are:7

  • Balance sheet – shows assets versus liabilities at a given point in time
  • Income statement – lists money coming in and going out for a specific period
  • Cash flow statement – shows cash-based exchanges during a specific time

Accountants are also sometimes responsible for making recommendations based on the company’s current financial health or status. That makes this more of an advisory role versus simply keeping the numbers organized and in balance.

Additionally, if you work as a bookkeeper or accounting clerk within a large company, tasks are typically more specialized according to the BLS.1 For example, if you work within the accounts payable department, your duties may revolve solely around the accounts that are due and owing to the company, whereas if you work in accounts receivable, your focus would be on incoming monies instead.

Analytical Skills

Because accountant roles require an analysis of the accounts versus simply the inputting of numbers, individuals working in this type of position also benefit from having analytical skills.8 The better you’re able to analyze the company’s financial data to gain a clearer idea of what it means, the easier it is to offer recommendations about how to move forward.

Pay Potential

When discussing how much you can earn in an accounting role, it’s important to note that pay for both of these positions can vary tremendously based on a variety of factors. Some of these factors include your level of education and experience, certifications, and where you live and work geographically.

With this in mind, pay can also vary between bookkeepers and accountants. The BLS reports that bookkeepers earn a median annual pay of $47,440 per year as of May 2023.9 However, if you become an accountant, the median pay per year as of May 2023 is $79,880 annually.10

Why such a difference? The answer to this question lies, in part, with each one’s level of education, training, and certification requirements.

Education, Training, and Certification Requirements

Individuals working as accountants typically have at least a 4-year degree (a bachelor’s) in accounting or a similar field, though some businesses require their accountants to have a master’s.7 And if you plan to file reports with the SEC, the law requires that you be a Certified Public Accountant or CPA.

Each state has its own Board of Accountancy, which is the agency responsible for providing licensing for individuals wishing to offer accountant services within that particular jurisdiction. The National Association of State Boards of Accountancy offers contact information for Boards of Accountancy within each state.11

Another option is to earn your 2-year degree (an associate degree) and work as an accounting clerk or bookkeeper. This type of role generally requires some accounting courses and may include on-the-job training, better preparing new employees to take on the financial tasks for which they are assigned.12

Still Unsure Which Is Best for You?

Now that you have a clearer understanding of the differences between a bookkeeper and an accountant, it can become easier to choose a career path that makes the most sense for you.

Although we do not offer a program for becoming an accountant, we do offer a program for earning an associate degree in Healthcare Accounting which prepares students to pursue entry-level bookkeeping roles. Contact us today to talk about degree options and discuss which ones may help you achieve your career goals.


1 Bureau of Labor Statistics. Occupational Outlook Handbook. Bookkeeping, Accounting, and Auditing Clerks. https://www.bls.gov/ooh/office-and-administrative-support/bookkeeping-accounting-and-auditing-clerks.htm#tab-3
2 Bureau of Labor Statistics. Occupational Outlook Handbook. Accountants and Auditors. https://www.bls.gov/ooh/business-and-financial/accountants-and-auditors.htm#tab-3
3 Dellinger K. Protecting a taxpayer’s privileges. The Tax Adviser. https://www.thetaxadviser.com/issues/2022/aug/protecting-taxpayer-privileges.html
4 Association for Federal Enterprise risk Management. Wrong Numbers: The Risks of Inaccurate Financial Statements. https://www.aferm.org/erm_feed/wrong-numbers-the-risks-of-inaccurate-financial-statements/
5 Flynn T. Accounting ledgers: A beginner’s guide to ledgers. Intuit Quickbooks. https://quickbooks.intuit.com/r/bookkeeping/accounting-ledger/
6 Bureau of Labor Statistics. Occupational Outlook Handbook. Bookkeeping, Accounting, and Auditing Clerks. https://www.bls.gov/ooh/office-and-administrative-support/bookkeeping-accounting-and-auditing-clerks.htm#tab-2
7 Charles Schwab. 3 Financial Statements to Measure a Company’s Strength. https://www.schwab.com/learn/story/3-financial-statements-to-measure-companys-strength
8 Bureau of Labor Statistics. Occupational Outlook Handbook. Accountant and Auditors. https://www.bls.gov/ooh/business-and-financial/accountants-and-auditors.htm#tab-4
9 Bureau of Labor Statistics. Occupational Outlook Handbook. Bookkeeping, Accounting, and Auditing Clerks. https://www.bls.gov/ooh/office-and-administrative-support/bookkeeping-accounting-and-auditing-clerks.htm#tab-1
10 Bureau of Labor Statistics. Occupational Outlook Handbook. Accountant and Auditors. https://www.bls.gov/ooh/business-and-financial/accountants-and-auditors.htm#tab-1
11 National Association of State Boards of Accountancy. Boards of Accountancy. https://nasba.org/stateboards/
12 Bureau of Labor Statistics. Occupational Outlook Handbook. Bookkeeping, Accounting, and Auditing Clerks. https://www.bls.gov/ooh/office-and-administrative-support/bookkeeping-accounting-and-auditing-clerks.htm#tab-4

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About the Author

headshot of Adam FensterAdam Fenster

Adam Fenster is a senior copywriter at Ultimate Medical Academy, with journalism experience from his time as a reporter and editor for multiple online and print publications. Adam has been covering healthcare education since 2019, with an emphasis on topics such as wellness, healthcare employment, and job preparedness. He received his BA in journalism from the University of South Florida.

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