CONTROLLER

MedFleet, LLC; Tyler, Northern (TX, KY); Hybrid; USD 120,000 - 180,000; Full time

Job summary

PatientCare EMS in Franklin, TN is seeking a seasoned Controller to own month-end closing, revenue recognition, and multi-entity consolidation. You will lead audits, strengthen internal controls, and partner with leadership on budgeting and cash strategy.

The role requires healthcare accounting expertise, CPA preferred, and hands-on experience with Dynamics 365 BC and advanced Excel/BI tools. Office-based with cross-functional collaboration across billing and operations.

Qualifications

• Bachelor's degree in Accounting or Finance required.
• CPA licence strongly preferred (active or in progress).
• 5+ years of progressive accounting experience with supervisory responsibilities.
• Healthcare EMS accounting experience required.
• Solid knowledge of accrual accounting and US GAAP (ASC 606, ASC 842).
• Experience with multi-entity consolidated financial reporting.

Responsibilities

• Own the monthly, quarterly, and annual close process across multiple entities, ensuring GAAP-compliant statements.
• Manage revenue recognition including reserves for allowances, bad debt, payer mix adjustments.
• Drive ownership of Microsoft Dynamics 365 BC: COA, workflows, and reporting.
• Prepare balance sheet reconciliations, journal entries, and supporting schedules.
• Develop weekly cash flow analyses and support cash strategy discussions.
• Lead annual budget modeling with entity leaders, aligning to goals.
• Oversee audits (financial, regulatory, lender, payer) and liaison with external auditors.
• Develop, document, and enforce internal controls and accounting policies.
• Collaborate with brokers and auditors on insurance matters and cost controls.
• Support M&A activities with analyses and balance sheet coordination.
• Lead process improvements for reporting accuracy and efficiency.
• Partner with CFO on budgeting, forecasting, and cash management.
• Supervise accounting staff across AP, AR, payroll, and revenue cycle.
• Oversee fixed asset and ASC 842 lease accounting.

Skills

Leadership

Analytical thinking

Cross-functional collaboration

Communication skills

Integrity and discretion

Education

Bachelor's degree in Accounting or Finance

CPA license

Tools

Microsoft Dynamics 365 Business Central

Excel

Power BI

Solver

IDEA

Job description

• 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.

Qualifications

• 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.
• 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.

Travel Required

Yes . Occasionally

Equal Opportunity Employer
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