Manager – External Audit
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Role Description
The Mgr – External Audit will lead a variety of audits and advisory engagements and will directly supervise the claim audit team members and external third-party auditors. The role will include:
- Leading audits and presenting audit findings
- Assisting the Audit Coordinator in monitoring and managing findings from recurring claims quality assurance audits
- Identifying root causes and offering recommendations for positive change
- Conducting audit planning and supervising fieldwork
- Ensuring compliance with Global Internal Audit Standards and G.E.H.A Internal Audit methodologies
- Providing expertise in the review, research, and analysis of claim exceptions
- Delivering training to less experienced team members
- Adhering to corporate policies and professional ethical standards
- Communicating with G.E.H.A employees, management, vendors, and contractors
Qualifications
- Requires a college degree (BA/BS) from an accredited college/university
- 5 to 8 years of relevant audit and/or claim processing experience
- 3 or more years of leadership experience
- Superior analytical, research, and critical thinking skills
- Project, organizational, and time management skills
- Leadership skills with the ability to motivate and influence
- Strong verbal, written, and interpersonal communication skills
- Proficiency in Microsoft Office Applications (Excel is critical)
- Working knowledge of claims processing, medical terminology, and medical codes
- Knowledge of claim system configuration, Claims (Medical/Dental), Enrollment, or Internal Operations functions
- Ability to work independently and prioritize workflow
Requirements
- Experience with data analytics software and tools preferred (e.g., IDEA, PowerBI, SQL)
- Ability to provide a non-cellular High Speed Internet Service for a home office
- Minimum standard speed for optimal performance of 30×5 (30mpbs download x 5mpbs upload)
- Latency (ping) response time lower than 80 ms
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Benefits
- Competitive pay/salary ranges
- Incentive plan
- Health/Vision/Dental benefits effective day one
- 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
- Robust employee well-being program
- Paid Time Off
- Personal Community Enrichment Time
- Company-provided Basic Life and AD&D
- Company-provided Short-Term & Long-Term Disability
- Tuition Assistance Program
