About Midlands Orthopaedics & Neurosurgery
Midlands Orthopaedics & Neurosurgery, P.A. is the only private practice physician group providing neurosurgical, orthopaedic, and pain management services in the Midlands of South Carolina. We pioneered the region’s transition of total joint replacement and spine surgery to the Ambulatory Surgery Center setting beginning in 2012, which has cultivated our reputation as the leader in high-quality, cost-effective musculoskeletal surgery. The practice has also led the region in price transparency and bundled surgery options — initiatives that underscore decades of clinical excellence, operational stability, and agility in a collaborative, physician-led environment.
The Opportunity
We are seeking an experienced and detail-oriented Controller to lead all accounting, payroll, and banking functions for the practice. This hands-on operational role needs a finance professional who takes genuine satisfaction in doing the work — maintaining accuracy, ensuring compliance, and running a clean, efficient accounting operation.
We are looking for a skilled accounting leader who takes pride in technical excellence, values stability, and finds deep professional satisfaction in owning the numbers without responsibility for financial strategy.
Our stable, predictable environment has no health system bureaucracy, no heavy travel, and no 24/7 demands. Standard business hours, a supportive culture, low turnover, and tenured staff make this an exceptional opportunity for a professional who values quality of work-life.
The right candidate will also be an effective communicator — able to translate financial data into clear, direct answers when the CEO or physician owners ask pointed questions. While not a strategic role per se, it does require the ability to explain the numbers confidently and succinctly to a sophisticated, results-oriented audience.
What You Will Do
General Accounting & Financial Reporting
- Own the full general ledger, month-end and year-end close processes
- Prepare and distribute accurate financial statements and management reports on a timely basis
- Maintain the chart of accounts and ensure consistent, compliant accounting practices
- Coordinate with external auditors, tax preparers, and local tax authorities; provide all supporting documentation
- Ensure compliance with applicable healthcare accounting standards and bank covenants
Payroll & Retirement Pan
- Manage all payroll processing for approximately 200 employees across applicable pay structures
- Administer physician compensation calculations in accordance with the practice’s established compensation formula
- Ensure accurate and timely payroll tax deposits, filings, and year-end reporting (W-2s, 1099s)
- Maintain payroll records and coordinate with HR on benefit deductions, garnishments, and changes
- Serve on the retirement plan committee and work with external advisors to manage and oversee Practice’s employer sponsored retirement plan
Banking & Cash Management
- Manage daily banking operations including deposits, disbursements, and account reconciliations
- Monitor cash flow and maintain adequate operating balances
- Manage relationships with banking institutions for routine operational matters
Accounts Payable & Vendor Relations
- Supervise timely and accurate processing of all vendor invoices and payments
- Maintain vendor records and ensure proper 1099 documentation
- Support CEO as additional liaison for insurance brokers (health, malpractice, and property & casualty)
Internal Controls & Compliance
- Maintain and enforce internal controls appropriate for a physician-owned medical practice
- Ensure compliance with applicable state and federal financial reporting requirements
- Safeguard practice assets and ensure accurate record retention
Team Leadership
- Directly supervise and develop 2 accounting staff members
- Assign and review work product, provide ongoing feedback, and support professional growth within the accounting function
Professional Engagement
- Attend OrthoForum meetings and participate in the OrthoForum Finance Group Listserv as a representative of the practice
What We’re Looking For
Required Qualifications
- Bachelor’s degree in Accounting, Finance, or related field
- Minimum 8 years of progressive accounting experience, including supervisory responsibility
- Demonstrated proficiency in full-cycle accounting and payroll administration
- Experience with accounting software
- Strong working knowledge of accounting principles and payroll tax compliance
- High proficiency in Microsoft Excel and financial reporting tools
Preferred Qualifications
- Experience in physician practice, ambulatory surgery center, or healthcare accounting
- Familiarity with physician compensation models and distribution calculations
- Experience with practice management system integrations and financial data reconciliation
- Experience with cloud-based financial applications to include Sage Intacct and Ramp
Who You Are
- You are a “finisher” — you take a task from start to clean completion and sleep well knowing the books are right.
- You are energized by technical accuracy, not by strategy decks or board presentations.
- You value autonomy, stability, and the satisfaction of running a tight accounting operation.
- You are a steady, dependable leader who develops your team through example and clear expectations.
- You communicate effectively with physicians, administrators, and staff at all levels.
- You can explain the numbers — when the CEO or a physician owner asks a pointed question, you respond with clarity and confidence, translating complex financial data into direct, accessible answers.
Why Join Our Practice
- Stable, established independent physician-owned practice with decades of clinical excellence and strong financial performance
- Collaborative, physician-led leadership team that values operational excellence
- Competitive base salary plus performance-based bonus
- Comprehensive benefits package including health, dental, and vision coverage; 401(k) and CME/professional development allowance
- Outstanding work-life balance: standard business hours, minimal after-hours demands, and a culture that values your expertise without burnout
How To Apply
Qualified candidates should submit a resume and cover letter: employment@midorthoneuro.com.
We look forward to hearing from candidates who are ready to own the numbers and make a lasting contribution to our practice.
