Financial Controller

About Us:

Here at Ambience, we never set out to be just another scribe. We’re building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country.

Our technology helps providers focus on delivering great care by removing the administrative burden that pulls them away from patients and away from their most impactful work. Ambience delivers real-time coding-aware documentation and clinical workflow support across ambulatory, emergency and inpatient settings at the top health systems in North America.

Our teams operate relentlessly with extreme ownership to build the best solutions for our health system partners. We value candor, positivity and deep thought — and we expect a lot from each other because we know the problems we’re solving truly matter.

Ambience was ranked #1 for Improving the Clinician Experience in the KLAS Research Emerging Solutions Top 20 Report, recognized by Fast Company as one of the Next Big Things in Tech, named one of the best AI companies in healthcare by Inc., and selected as a LinkedIn Top Startup in 2024 and 2025. We’re backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, and Kleiner Perkins — and we’re just getting started.

About the role

We are hiring a Controller to build a scalable, best-in-class accounting function. You will own the monthly close, internal controls, accounting policy, tax compliance, treasury, and compliance, and you will own Ambience's annual external audit. You will partner closely with the VP Finance to shape our financial strategy and serve as the senior accounting voice across the company. This is a hands-on, build-from-the-ground-up role for someone who wants to set the standard for how a high-growth company keeps trustworthy books.

Please note: for this role, SF Bay Area is preferred, however the team is open to candidates based across the USA who would be willing to travel to SF for occasional in-office work (approx 1-3x/quarter).

What you'll do

Own U.S. GAAP-compliant financial statements and the monthly close, bringing process in-house and making it scalable.

Own the annual external audit - preparation, execution, documentation, controls, and reconciliations - and serve as primary auditor liaison.

Establish core accounting policies: revenue recognition (ASC 606), expense management, capitalization, and lease accounting (ASC 842).

Own indirect tax compliance including multi-state SaaS nexus analysis, registration, and remittance. Manage the relationship with external tax advisors for federal and state income tax provision and filings.

Own treasury operations including cash management, disbursements, and bank relationships.

Evaluate and implement accounting systems and automation; streamline the end-to-end order-to-cash process with the deal desk.

Build and lead the accounting team, and manage the outsourced accounting partner (Attivo) for bookkeeping, review, and reconciliation.

Partner with finance and operations on variance analysis, pipeline-to-ARR tracking, and MD&A for leadership and the Board.

Partner with the VP Finance on financial strategy, reporting to the Board, and building the infrastructure to support Ambience's next phase of growth.

Collaborate cross-functionally with Legal, Deal Desk, People, and Product to ensure accounting treatment keeps pace with new contract structures, headcount growth, and product launches.

What you'll bring

8+ years of progressive accounting experience, including at least 2 years in a Controller or Assistant Controller role at a high-growth or venture-backed company.

Deep U.S. GAAP expertise, including revenue recognition (ASC 606), stock-based compensation, and capitalization.

Demonstrated experience leading or supporting an external audit and standing up internal controls.

A track record building scalable close processes and selecting or implementing accounting systems.