Senior Auditor (Regulatory)
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together, we will achieve our mission to enhance the health and well-being of the people and communities we serve.
The ideal candidate for the Senior Regulatory Auditor position will be an excellent communicator (written and verbal) who is detail-oriented and organized. He/she will also be able to work independently and with a team, demonstrating self-motivation and enthusiasm. The Senior Regulatory Auditor will be performing risk-based audits concerning the operation and regulatory compliance of the Company.
Responsibilities:
· Plan, coordinate, and lead key financial, operational, and regulatory audits of the Company and its subsidiaries.
· Develop audit programs by working with the Company and department Management.
· Document processes and controls by utilizing flowcharts and/or narratives.
· Perform substantive and control testing.
· Make recommendations and develop corrective action plans based on testing results and partner with impacted business areas on remediation efforts.
· Develop draft audit reports for audits and special projects. Assist in preparing the final versions of audit reports.
· Perform follow-up on the status of recommendations made in previous audit reports.
· Review and determine how federal and state regulatory requirements impact the Company and assist in the evaluation of the Company's compliance with such requirements, including but not limited to, the Affordable Care Act and Medicare.
· Assist in the coordination of reviews completed by external regulatory bodies as needed (i.e., market conduct exams).
· Communicate effectively with all levels of management.
· Utilize data analytics during the planning and execution of planned audits to help achieve more comprehensive coverage of risk mitigation.
· Perform ad hoc projects as applicable.
Qualifications:
· Bachelor’s degree in accounting, business, healthcare, or equivalent work experience
· Three-plus years of audit experience in a large public accounting firm or healthcare setting preferred
· Previous experience leading or performing audits independently
· Knowledge of commercial, Medicare Advantage, and/or self-funded insurance plans and third-party administrator operations and regulations (e.g., ACA/CMS/ERISA/DOL) preferred
· Knowledge of auditing, accounting systems, flowcharting, and statistical sampling techniques
Additional Skills/Experience:
· Previous insurance or healthcare audit experience preferred
· Strong oral and written communication skills
· Strong attention to detail with the ability to work on multiple projects simultaneously
· Ability to work independently and as part of a team
· CPA, CIA, or JD certification preferred
· Advanced degree (MBA, MHA, etc.) is a plus
· Proficient to advanced skillset working in and knowledge of Microsoft Office tools (i.e., MS Excel, MS Word, MS PowerPoint, Copilot) preferred
· Previous experience with ACL or other audit software a plus
· Tableau, SQL, or database knowledge a plus
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.