About The Helm ABA
The Helm ABA provides Applied Behavior Analysis (ABA) therapy to children with autism and their families across multiple clinic locations in North Texas. Our Board-Certified Behavior Analysts (BCBAs) and Registered Behavior Technicians (RBTs) deliver individualized, evidence-based care, and we are growing, with new locations and an in-home service line on the way. Strong financial management is what lets us keep investing in our clinicians, open our doors to more families, and deliver care that lasts.
Position Summary
The Controller owns The Helm ABA’s accounting operations, financial reporting, internal controls, budgeting support, and financial compliance. This role ensures the accuracy and integrity of our financial records and gives the CEO and leadership team timely, reliable information on clinic performance, clinician productivity, payer reimbursement, and cash, so we can make sound decisions as we grow. ABA is a labor-intensive, insurance-reimbursed business: revenue depends on authorized hours actually delivered, documented, billed, and collected, and our largest cost is the clinical team delivering that care. The ideal Controller understands that connection, is detail-oriented, analytical, and proactive, and is excited to build scalable finance processes in a growing, multi-location healthcare organization.
Essential Duties and Responsibilities
- Accounting & Financial Reporting
- Oversee daily accounting operations, including general ledger, accounts payable, accounts receivable, reconciliations, and journal entries.
- Manage monthly, quarterly, and annual close processes on a consistent, timely calendar.
- Prepare and review financial statements, including the income statement, balance sheet, and cash flow statement, with clinic-level & for each location.
- Ensure financial records are maintained in accordance with GAAP, including revenue recognition under ASC 606 for patient service revenue net of contractual adjustments and expected payer concessions.
- Maintain accurate accounting across all clinic locations, service lines (center-based and in- home), and corporate departments using a consistent chart of accounts and cost-center structure.
- Analyze financial results, identify variances, and communicate findings and recommendations to the CEO and leadership team.
- Budgeting, Forecasting & Financial Analysis
- Lead the 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 on core ABA metrics such as authorized vs. delivered hours (authorization utilization), session cancellations, BCBA and RBT billable productivity, caseload, and supervision ratios.
- Model the financial impact of payer mix, reimbursement rate changes, staffing levels, and wage or incentive changes.
- Partner with Operations and Clinical Leadership to identify cost-saving opportunities and improve clinic profitability without compromising quality of care.
- Revenue Cycle, Cash Flow & Payer Reimbursement
- Monitor cash flow, working capital, and liquidity, and maintain a 13-week cash forecast.
- Oversee the financial side of the revenue cycle in partnership with our outsourced billing partner, BillMax, from authorization and charge capture through claims, payment posting, denials, and collections.
- Reconcile delivered and documented sessions in the practice management system to billed claims and to cash received to identify unbilled services and revenue leakage.
- Track A/R aging, days sales outstanding (DSO), clean claim rate, denial trends, and collection rates by payer, including commercial insurers, Texas Medicaid and its managed care organizations, and TRICARE.
- Hold BillMax accountable to agreed service levels, and monitor payer reimbursement against contracted rates by CPT code (e.g., 97151–97158) and flag underpayments, rate discrepancies, and opportunities for contract renegotiation.
- Estimate and maintain appropriate reserves for contractual allowances, bad debt, and potential payer recoupments.
- Payroll & Clinical Workforce Costs
- Ensure payroll expenses, employer taxes, benefits 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 vs. non-billable time (training, supervision, cancellations, drive 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
incentive programs for clinical staff.
- Internal Controls & Compliance
- Develop, implement, and maintain accounting policies, procedures, and internal controls appropriate for a growing healthcare provider.
- Partner with Clinical and Compliance leadership to make sure billing is supported by documentation, authorizations, and credentialed providers, and that we are prepared 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 line 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.
- Systems & Process Improvement
- Evaluate and improve accounting, payroll, and reporting systems, and their integration with our ABA practice management and billing platform.
- Standardize financial processes and reporting across all clinic locations so new sites can be onboarded quickly and consistently.
- 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.
- Growth & Executive Partnership
- Provide financial insights and recommendations to the CEO and leadership team, including a monthly financial reporting package that highlights 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 performance of 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, providing financial analysis, risk
Qualifications
Education
- Bachelor’s degree in accounting, Finance, or a related field required.
- CPA preferred.
Experience
- Five or more years of progressive accounting or finance experience.
- Prior experience as a Controller, Assistant Controller, Accounting Manager, or similar financial leadership role preferred.
- Experience overseeing accounting for a multi-location organization required; experience supporting new location openings a plus.
- Healthcare provider experience is strongly preferred, ideally in ABA, behavioral health, pediatric therapy (speech, OT, PT), home health, or another insurance-reimbursed outpatient setting.
- Working knowledge of healthcare revenue cycle, including authorizations, claims, payment posting, denials, contractual adjustments, and payer reimbursement (commercial and Medicaid).
- Experience with financial reporting, reconciliations, budgeting, payroll accounting, and audit preparation required.
- Experience in a private equity or investor-backed company, including lender or board reporting, a plus.
Technical Skills
- Strong knowledge of GAAP and healthcare revenue recognition.
- Advanced Microsoft Excel skills and proficiency with QuickBooks Online (QBO) required, including class/location tracking for multi-entity or multi-location reporting.
- Experience with ABA or healthcare practice management and billing systems (e.g., CentralReach, Rethink, or similar) preferred.
- Experience with multi-location financial reporting, cost-center accounting, and KPI dashboards.
- Ability to analyze financial and operational data and present findings clearly to non-financial leaders, including clinicians.
- Experience managing an outsourced billing or revenue cycle vendor preferred.
- Experience improving accounting workflows, controls, and reporting processes.
Core Competencies
- 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
Don’t meet every single requirement? Apply anyway. We value potential, purpose, and personality just as much as experience.
Let’s navigate this journey together. 💙