Controller

Controller

The Controller is responsible for overseeing all accounting, financial reporting, and revenue cycle operations for a growing diagnostic laboratory organization (~$20M in annual revenue). This role ensures the integrity of financial data, compliance with healthcare regulations, and efficient management of billing, collections, and cash flow. The ideal candidate is both technically strong in accounting and operationally experienced in healthcare revenue cycle, with the ability to improve financial performance in a highly regulated environment.

Accounting & Financial Operations

Lead all accounting functions including general ledger, accounts payable/receivable, payroll, and financial close. Manage monthly, quarterly, and year-end close processes to ensure timely and accurate financial statements. Maintain financial records in compliance with GAAP. Develop and enforce accounting policies, procedures, and internal controls.

Revenue Cycle Management

Oversee medical billing, collections, and reimbursement processes (Medicare, Medicaid, and commercial payers). Monitor and improve key metrics such as Days in AR, collections rate, and denial rates. Partner with billing team to resolve claim issues, optimize coding, and improve reimbursement outcomes. Analyze payer mix, reimbursement trends, and aging reports.

Financial Reporting & Analysis

Prepare monthly financial statements, management reports, and dashboards. Provide analysis on revenue, margins, test volumes, and cost per test by service line. Identify financial trends and present actionable insights to executive leadership. Support strategic decision-making through financial modeling and analysis.

Compliance

Ensure compliance with all applicable healthcare regulations (e.g., CLIA, payer requirements). Maintain audit-ready financial records and documentation. Coordinate with external auditors, tax advisors, and regulatory agencies. Ensure timely and accurate completion of tax filings and reporting.

Budgeting & Forecasting

Lead the annual budgeting process and ongoing financial forecasting. Monitor performance against budget and analyze variances. Identify opportunities for cost control and operational efficiency. Cash Flow & Working Capital Manage cash flow, liquidity, and working capital. Improve cash collections and optimize reimbursement timing. Monitor banking relationships and internal financial controls.

Leadership & Cross-Functional Collaboration

Manage and develop accounting staff. Collaborate with billing, lab operations, and executive leadership teams. Build scalable financial processes to support growth. Support potential expansion initiatives, new service lines, or acquisitions.

Qualifications

Bachelor's degree in Accounting, Finance, or related field. CPA strongly preferred. 7–12+ years of progressive accounting/finance experience. Experience in healthcare, diagnostic laboratory, or pathology strongly preferred. Strong knowledge of GAAP, internal controls, and financial reporting. Experience with medical billing, reimbursement models, and revenue cycle management. Proficiency with ERP systems and healthcare billing platforms.

Key Competencies

Deep understanding of healthcare revenue cycle and payer dynamics. Strong analytical and problem-solving skills. High attention to detail and accuracy. Ability to operate in a hands-on, fast-paced environment. Excellent leadership and communication skills. Strong sense of ownership and accountability.

Reporting Structure

Reports to: CFO or CEO. Direct Reports: Accounting Manager, Staff Accountant(s), Billing Manager (or dotted-line oversight).

Work Environment

Requires collaboration with both finance and operational teams. May require extended hours during month-end and year-end close.

Preferred Experience (Strong Plus)

Diagnostic lab specialties (pathology, molecular, or genetic testing). Experience in high-growth or private equity-backed healthcare organizations. Familiarity with lab information systems (LIS) and revenue cycle analytics tools.

What Success Looks Like

Accurate and timely financial reporting. Reduced Days in AR and improved cash collections. Clean audits and strong compliance posture. Clear financial visibility into profitability and operations.