Own the General Ledger. Build the Function.
Northwest Ambulance is bringing its accounting in house. Today the books are on a cash basis, a portion of the work sits with an outside bookkeeping provider, and no single person owns the general ledger or the judgments behind it. We are hiring an Accounting Manager to change that.
This is not a role where you inherit a closed system and keep it running. You will decide how transactions get recorded, design the close and reconciliation framework, lead the conversion from cash to accrual, and determine what comes in house from the external provider, in what order, and under what controls. The transactional work is yours to do for now — but the reason the job exists is the judgment, not the data entry.
You will report to the Controller and work closely with the Payroll Manager, operating leadership, our outsourced billing provider, and our external accountants. There is no accounting staff today; as the function grows, so does the role.
What You’ll Own
Accounting judgment and policy. Determine the right treatment under US GAAP — revenue recognition, accruals, deferrals, prepaids, capitalization — and document the reasoning. Write the accounting policies and internal controls that become the company standard, and interpret them for everyone else.
The cash-to-accrual conversion. Plan it and execute it, including establishing and supporting opening accrual balances. Then design the close calendar, the balance sheet reconciliation framework, and the workpaper structure that keep it intact.
Financial reporting. Prepare and analyze monthly financial statements, investigate and explain variances, and advise the Controller and operating leadership on the reporting consequences of business decisions before they are made.
Transaction cycles and external parties. Review accounts payable and authorize disbursements within delegated limits. Maintain the vendor master and 1099 determinations. Reconcile the outsourced billing provider to the general ledger and resolve the differences. Represent the company to vendors, external accountants, auditors, and taxing authorities.
Assets and systems. Apply the capitalization policy, maintain fixed asset and depreciation schedules, and evaluate accounting systems and automation tools — then lead the implementations you recommend.
Continuity. Serve as trained backup for payroll processing, act for the Controller on defined matters during absences, and document the function well enough that someone else could close a month without you.
Requirements
What We’re Looking For
● Bachelor’s degree in accounting or a closely related field.
● Five or more years of progressively responsible accounting experience.
● Demonstrated ability to independently determine accounting treatment and defend it under review.
● Working knowledge of both cash-basis and accrual-basis accounting, and familiarity with cash-to-accrual conversion.
● Solid US GAAP fundamentals — revenue recognition, accruals, and deferrals.
● Ability to reconcile balance sheet accounts and trace a variance to its source without help.
● Advanced QuickBooks and strong Excel, including work with large data extracts.
● The judgment to make calls that carry real financial consequence, and the discipline to fix a discrepancy at its source rather than paper over it downstream.
Nice to Have
● CPA, CMA, or comparable accounting certification.
● Experience leading or supporting a cash-to-accrual conversion.
● Healthcare, EMS, or another third-party payer billing environment.
● Experience reconciling to an outsourced billing company, including accounts receivable roll forwards and aging analysis.
● Experience bringing accounting work in house from an external bookkeeping provider.
● Experience automating close or accounts payable workflows, or working with AI tools as part of daily practice.
● Prior supervisory or team leadership experience.
Benefits
We offer a comprehensive benefits package that includes medical, dental, and vision insurance to ensure the well-being and health of our employees.
Eligible employees who are scheduled to work on a designated company holiday will receive holiday pay in accordance with Northwest Ambulance policy.
We invest in your future with a 401(k)-retirement plan that includes an employer match of up to 5%, helping you build a long-term financial security.
We value work-life balance and offer paid time off, giving you the flexibility to rest, recharge, and take care of what matters most.
Wages:$56 - $67 or hour, approximately $116,000 – $139,000 annually. Where an offer lands in the range depends on experience and qualifications.
Equal Opportunity Employer
Northwest Ambulance is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Reasonable accommodations are available upon request for candidates with disabilities participating in the application or interview process.
Skills Required
- Bachelor's degree in accounting or a closely related field
- Five or more years of progressively responsible accounting experience
- Ability to independently determine accounting treatment and defend it under review
- Working knowledge of cash-basis and accrual-basis accounting
- Familiarity with cash-to-accrual conversion
- Solid US GAAP fundamentals, including revenue recognition, accruals, and deferrals
- Ability to reconcile balance sheet accounts and trace variances to their source independently
- Advanced QuickBooks proficiency
- Strong Excel skills, including working with large data extracts
- Sound judgment for financially consequential accounting decisions
- CPA, CMA, or comparable accounting certification
- Experience leading or supporting a cash-to-accrual conversion
- Healthcare, EMS, or third-party payer billing experience
- Experience reconciling to an outsourced billing company, including accounts receivable roll-forwards and aging analysis
- Experience bringing accounting work in-house from an external bookkeeping provider
- Experience automating close or accounts payable workflows, or using AI tools in daily practice
- Prior supervisory or team leadership experience
What We Do
Northwest Ambulance Critical Care Transport is a locally run BLS, ALS, and Critical Care transport service serving Seattle and the Pacific Northwest, dedicated to providing the very best care to its communities and employees.









