Controller

About Us

Here at Ambience, 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 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.

Key Responsibilities

• 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 the 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.

Requirements

• 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 of building scalable close processes and selecting or implementing accounting systems.

• Strong cross-functional communication; able to translate accounting into clear narratives for non-finance partners, leadership, and the Board.

• CPA required. Big 4 or national firm public accounting experience strongly preferred.

Nice to Have

• Experience leading a company's annual audit at a venture-backed company (Series B-D).

• Familiarity with NetSuite or a comparable ERP and modern close tooling.

• Healthcare or SaaS revenue recognition experience.

Life at Ambience

Working at Ambience means opting into a high-ownership, high-trust environment built for people who want to grow fast, operate decisively, and focus on work that matters.

• Work on mission-critical AI technology that directly improves clinicians’ day-to-day lives and health system financial health across some of the most complex, high-stakes workflows in the world.

• Join a “dream team” culture where we hire exceptional people, expect exceptional outcomes, and invest deeply in feedback and continuous growth. We operate as a championship team, and that means being okay with hard, uncomfortable, ambiguous problems that lead to real greatness.

• Operate with real ownership and accountability in an environment where there are no bystanders: If something is broken, we fix it! You will have meaningful autonomy and be expected to drive work to completion.

To help you do your best work, we pair these expectations with benefits intentionally designed to help you feel supported and safe at Ambience and beyond.

• Comprehensive medical, dental, and vision coverage for you and your dependents

• 401(k) with a company match of up to 3% of base salary

• A remote-friendly culture (with a San Francisco HQ) and full equipment provisioning to ensure you can work effectively from wherever you’re based.

• Parental leave to support your family needs

• Annual company-wide off-sites, team off-sites, and regular team lunches and all-hands gatherings, with travel, lodging, and meals covered

• Flexible time off with no annual cap, company-wide holidays, and an annual holiday shutdown from December 24–January 1 designed to support real rest and long-term sustainability.