Director of Finance

Fcsith; Town of Ithaca (NY); On-site; USD 120,000 - 170,000; Full time

Job summary

Fcsith in Ithaca, NY seeks a seasoned finance leader to oversee the organization’s revenue cycle, accounting, and compliance functions. The role collaborates with clinical and administrative teams to ensure accurate financial reporting and policy adherence.

The ideal candidate has 5+ years in nonprofit finance, strong GAAP expertise, and experience with QuickBooks Online, Bill.com, and EHR systems. Leadership, budgeting, and strategic planning are key components of this position.

Qualifications

• Minimum 5 years nonprofit or related finance experience with audit coordination.
• Strong GAAP, fund accounting, nonprofit compliance understanding.
• Proficiency with QuickBooks Online, Bill.com, EHR software, and advanced Excel.

Responsibilities

• Directly supervise, mentor, and evaluate the billing team in revenue cycle management.
• Participate in strategic planning, budgeting, and board presentations.
• Provide financial analysis to support priorities, service expansion, and resource allocation.
• Oversee full revenue cycle from service entry to cash receipt with cross-team collaboration.
• Ensure compliance with payer contracts and Medicaid/OMH regulations.
• Develop, document, and maintain billing, reconciliation, and write-off policies.

Skills

Leadership

Financial analysis

GAAP knowledge

Communication

Staff supervision

Education

Bachelor's or Master’s in Accounting/Finance

Tools

QuickBooks Online

Bill.com

Excel

EHR software

Job description

Description

Responsibilities

Departmental & Personnel Leadership

• Directly supervise, mentor, and evaluate the billing team, fostering a collaborative, accountable, and high-performing revenue cycle team.
• Serve as part of the management team, contributing to strategic planning, budgeting, and high-level decision-making.
• Provide clear, actionable financial analysis to support agency priorities, service expansion, and resource allocation.
• Attend and present at Board and Finance Committee meetings, translating financial performance into accessible, mission-linked narratives.

Revenue Cycle & Healthcare Billing Oversight

• Provide strategic oversight for the organization’s full revenue cycle, from service entry through cash receipt, in close partnership with the billing, support, and clinical teams.
• Monitor key revenue-cycle metrics, claim denial trends, accounts receivable aging, and reimbursement efficiencies.
• Ensure accurate recording of earned revenue, receivables, and contractual adjustments in alignment with GAAP and funder requirements.
• Reconcile billing data to the general ledger monthly, actively identifying and resolving discrepancies between clinical billing software/EHR platforms and financial systems.
• Ensure strict compliance with payer contracts, billing documentation standards, and behavioral healthcare/OMH/Medicaid regulations.
• Develop, document, and maintain agency-wide policies for billing, receipting, reconciliation, and write-off approvals.

Financial Management, Accounting & Compliance

• Oversee all accounting functions including accounts payable, accounts receivable, bank reconciliation, and journal entries.
• Maintain and enforce internal controls that safeguard assets and ensure compliance with GAAP, nonprofit, and behavioral healthcare regulations.
• Ensure timely and accurate month-end and year-end closings, including coordination with external auditors.
• Develop and monitor annual budgets and rolling forecasts in collaboration with department heads.
• Oversee maintenance of restricted net asset schedules, grant tracking, and comprehensive financial/contractual reporting obligations.
• Manage banking relationships, investment accounts, cash flow, and liquidity for operating needs.
• Serve as system owner for financial and integrated software platforms (e.g., QuickBooks Online, Bill.com, and related integrations), ensuring proper configuration, security, and user access workflows.
• Partner closely with HR on payroll integration, benefits reconciliation, and compliance.
• Assist with other assignments and tasks at the discretion of the Executive Director.

Requirements

Minimum Qualifications:

• Minimum of 5 years of progressive nonprofit or related finance experience, including audit coordination and reporting, with extensive background and proven experience in healthcare billing environments and revenue cycle management.
• Strong understanding of GAAP, fund accounting, healthcare billing regulations (such as Medicaid/OMH guidelines), and nonprofit compliance.
• Proficiency with QuickBooks Online, Bill.com, medical billing/EHR software, and advanced Excel (experience with Paylocity a plus).
• Proven experience in staff supervision, team development, and leading both strategic planning and hands-on financial operations.
• Excellent communication, organizational, and analytical skills.

Preferred Qualifications:

• A Bachelor’s or Master’s degree specifically in Accounting, Finance, or Business Administration.
• Significant experience managing unique non-profit fiscal operations, including grant tracking and reporting.
• Experience with centralized data management frameworks and pulling data from disparate software platforms (e.g., QuickBooks, Payroll systems, and EHRs).
• Background in oversight of medical coding/billing, as well as insurance regulation compliance in a healthcare setting.
• Demonstrated ability to balance short and long-term financial strategy in an ever changing healthcare climate with small financial margins.