Financial Controller

PatientCare EMS is seeking an experienced Controller to lead day-to-day accounting operations and strengthen financial reporting across the organization. Reporting directly to the CFO, the Controller will own the monthly close process, ensure accrual-basis and GAAP-compliant financial statements, and oversee revenue recognition for a complex, multi-payer healthcare reimbursement environment. This is a hands-on leadership role for someone who understands the operational and regulatory realities of healthcare finance — EMS billing and reimbursement experience is a strong plus.

•     Own the monthly, quarterly, and annual close process across a multi-entity organization, ensuring timely and accurate financial statements prepared in accordance with GAAP, on an accrual basis, and in compliance with lender covenants.

•     Manage revenue recognition for healthcare/EMS services, including reserves for contractual allowances, bad debt, payer mix adjustments, and third-party reimbursement timing.

•     Serve as the primary system owner for Microsoft Dynamics 365 Business Central, including chart of accounts maintenance, workflow configuration, and reporting.

•     Prepare and review balance sheet reconciliations, journal entries, and supporting schedules; maintain a clean, audit-ready general ledger.

•     Develop weekly cash flow analyses and support cash strategy discussions with ownership/investor groups.

•     Lead the annual budget modeling process in coordination with entity-level operations leaders, aligning budgets with company goals and operational realities.

•     Lead the annual financial statement audit and any regulatory, lender, insurance, or payer-related audits; serve as primary point of contact for external auditors and tax preparers.

•     Develop, document, and enforce internal controls and accounting policies to safeguard assets, mitigate risk, and ensure compliance with GAAP and applicable healthcare regulations.

•     Partner with brokers, actuaries, and auditors to evaluate insurance needs, monitor premiums, and identify opportunities for cost savings and risk mitigation, including managing policy renewal preparation and coordination, coverage reviews, and claims payment coordination. Coordinate insurance program administration to ensure appropriate coverage, accurate exposure reporting, and compliance with contractual and regulatory requirements.

•     Support M&A activity, including preparation of M&A-related financial analyses such as purchase price allocation, fair value assessments, goodwill and intangible asset valuation, and transaction-related accounting, as well as opening balance sheets, implementation of company controls, and coordination of valuation work with external parties.

•     Lead process optimization projects to improve the accuracy and efficiency of internal reporting and controls.

•     Partner with the CFO on budgeting, forecasting, and cash flow management.

•     Supervise, mentor, and develop accounting staff (AP, AR, payroll, revenue cycle, and staff accountants as applicable).

•     Oversee fixed asset accounting, lease accounting (ASC 842), and other technical GAAP areas relevant to the business.

•     Prepare management reporting packages and ad hoc financial analysis for the CFO and executive leadership.

•     Ensure compliance with healthcare billing/reimbursement accounting requirements and coordinate with billing/revenue cycle teams as needed.

•     Bachelor's degree in Accounting or Finance required.

•     CPA license strongly preferred (active or in progress considered).

•     5 years of progressive accounting experience, including supervisory or management responsibility; prior public accounting/audit experience (e.g., Big 4 or national firm) a strong plus.

•     Healthcare industry accounting experience required; EMS or ambulance services experience strongly preferred.

•     Solid working knowledge of accrual accounting and U.S. GAAP, including revenue recognition (ASC 606), lease accounting (ASC 842), business combinations, and consolidations.

•     Experience with multi-entity organizations and consolidated financial reporting preferred.

•     Experience supporting M&A due diligence, opening balance sheet preparation, or acquisition integration a plus.

•     Hands-on experience with Microsoft Dynamics 365 Business Central strongly preferred; comparable mid-market ERP experience considered.

•     Strong Excel skills; experience with Power BI, Solver, IDEA, or similar reporting/analytics tools a plus.

•     Demonstrated experience managing or supporting external financial statement audits, and ideally lender or insurance audits.

•     Excellent analytical, organizational, and communication skills, with the ability to work cross-functionally with billing, operations, and executive leadership.

•     High level of integrity and discretion in handling confidential financial and patient billing information.

• This position is based at PatientCare EMS's office in the Franklin, TN area and is primarily an in-office role, reflecting the collaborative, hands-on nature of the close process and the finance team's day-to-day work with billing and operations.