Controller

The Helm ABA•Dallas, TX

10d

About The Position

The Controller owns The Helm ABA’s accounting operations, financial reporting, internal controls, budgeting support, and financial compliance. The role ensures accurate, reliable financial records and provides the CEO and leadership team with timely information about clinic performance, clinician productivity, payer reimbursement, and cash to support decisions as the organization grows. The role is focused on the financial dynamics of an insurance-reimbursed, labor-intensive ABA business, where revenue depends on authorized hours being delivered, documented, billed, and collected, and clinical labor is the largest cost. The Controller will build scalable finance processes for a growing, multi-location healthcare organization. The Controller oversees accounting and financial reporting; budgeting, forecasting, and analysis; cash flow and revenue-cycle oversight; payroll and clinical workforce cost accounting; internal controls and compliance; systems and process improvement; and financial support for growth and executive decisions. The position partners with the CEO, leadership, Operations, Clinical Leadership, HR, Compliance, and an outsourced billing partner, and coordinates with external accountants, auditors, tax preparers, lenders, and financial institutions.

Requirements

Bachelor’s degree in accounting, finance, or a related field.
At least five years of progressive accounting or finance experience.
Experience overseeing accounting for a multi-location organization.
Working knowledge of healthcare revenue-cycle processes, including authorizations, claims, payment posting, denials, contractual adjustments, and commercial and Medicaid payer reimbursement.
Experience with financial reporting, reconciliations, budgeting, payroll accounting, and audit preparation.
Strong knowledge of GAAP and healthcare revenue recognition.
Advanced Microsoft Excel skills.
Proficiency with QuickBooks Online, including class/location tracking for multi-entity or multi-location reporting.
Experience with multi-location financial reporting, cost-center accounting, and KPI dashboards.
Ability to analyze financial and operational data and clearly present findings to non-financial leaders, including clinicians.
Experience improving accounting workflows, controls, and reporting processes.
Analytical thinking and problem-solving.
High attention to detail and accuracy.
Integrity and sound financial judgment.
Strong organizational and time-management skills.
Effective communication and collaboration with clinical and operational teams.
Process-improvement mindset and accountability.
Ability to manage competing deadlines in a fast-growing organization.
Discretion in handling confidential financial and patient information.
Commitment to The Helm ABA’s mission of serving children with autism and their families.

Nice To Haves

CPA.
Prior experience as a Controller, Assistant Controller, Accounting Manager, or in a similar financial leadership role.
Experience supporting new location openings.
Healthcare provider experience, ideally in ABA, behavioral health, pediatric therapy, home health, or another insurance-reimbursed outpatient setting.
Experience in a private equity or investor-backed company, including lender or board reporting.
Experience with ABA or healthcare practice management and billing systems, such as CentralReach, Rethink, or similar.
Experience managing an outsourced billing or revenue-cycle vendor.

Responsibilities

Oversee daily accounting operations, including the general ledger, accounts payable, accounts receivable, reconciliations, and journal entries.
Manage timely monthly, quarterly, and annual financial close processes.
Prepare and review income statements, balance sheets, and cash flow statements at clinic and location levels.
Maintain GAAP-compliant financial records, including ASC 606 revenue recognition for patient service revenue net of contractual adjustments and expected payer concessions.
Maintain consistent accounting across clinic locations, center-based and in-home service lines, and corporate departments using a standard chart of accounts and cost-center structure.
Analyze financial results and variances, and communicate findings and recommendations to the CEO and leadership team.
Lead development and monitoring of annual operating budgets and rolling forecasts by clinic, service line, and department.
Analyze revenue, labor costs, and operating margins by location, including revenue per billable hour, clinician cost per billable hour, and clinic contribution margin.
Build and maintain KPI reporting for ABA metrics, including authorization utilization, cancellations, BCBA and RBT billable productivity, caseload, and supervision ratios.
Model the financial impact of payer mix, reimbursement changes, staffing levels, and wage or incentive changes.
Partner with Operations and Clinical Leadership to identify cost savings and improve clinic profitability without compromising care quality.
Monitor cash flow, working capital, and liquidity, and maintain a 13-week cash forecast.
Oversee the financial aspects of the revenue cycle with outsourced billing partner BillMax, from authorization and charge capture through claims, payment posting, denials, and collections.
Reconcile documented and delivered sessions in the practice management system against billed claims and cash received to identify unbilled services and revenue leakage.
Track A/R aging, days sales outstanding, clean claim rate, denial trends, and collection rates by payer, including commercial insurers, Texas Medicaid managed care organizations, and TRICARE.
Monitor BillMax against service levels and compare payer reimbursement with contracted rates by CPT code; flag underpayments, rate discrepancies, and contract renegotiation opportunities.
Estimate and maintain reserves for contractual allowances, bad debt, and potential payer recoupments.
Ensure payroll expenses, employer taxes, benefit deductions, and retirement contributions are accurately recorded and allocated to the correct clinic and service line.
Partner with HR to reconcile payroll to the general ledger and resolve discrepancies.
Analyze clinical labor costs, including billable and non-billable time, overtime, and turnover-related costs for RBTs and BCBAs.
Oversee mileage and travel reimbursement processes as the in-home service line grows.
Reconcile payroll liabilities and employee benefit-related accounts.
Support the design and accurate calculation of productivity-based compensation, bonuses, and clinical staff incentive programs.
Develop, implement, and maintain accounting policies, procedures, and internal controls appropriate to a growing healthcare provider.
Partner with Clinical and Compliance leadership to ensure billing is supported by documentation, authorizations, and credentialed providers, and prepare for payer audits and record requests.
Ensure compliance with applicable federal and Texas requirements, including Medicaid program rules, tax obligations, and financial reporting standards.
Protect patient financial and health information in accordance with HIPAA requirements.
Coordinate with external accountants, auditors, tax preparers, lenders, and financial institutions; lead preparation for annual audits or reviews and tax filings.
Support lender and investor reporting, including covenant compliance calculations, as applicable.
Identify financial risks, investigate discrepancies, implement corrective actions, and safeguard company assets.
Evaluate and improve accounting, payroll, and reporting systems and their integration with ABA practice management and billing platforms.
Standardize financial processes and reporting across clinic locations to support consistent onboarding of new sites.
Build internal dashboards and financial tracking tools for leadership and clinic directors.
Identify opportunities to automate manual processes and reduce errors.
Maintain documentation supporting accounting procedures, reconciliations, and financial approvals.
Provide financial insights and recommendations to the CEO and leadership team, including a monthly reporting package highlighting significant variances and risks.
Build financial models and pro formas for new clinic locations and the in-home service line, including startup costs, leasehold improvements, ramp-up to break-even, and staffing plans.
Track new locations and service lines against their pro formas after launch.
Support analysis of capital expenditures, staffing and compensation decisions, payer contracting, and other strategic initiatives.
Serve as the primary internal finance partner to the CEO.