Senior Audit & Compliance Specialist developing audit schedules and conducting audits in insurance sectors. Collaborating with teams to drive quality improvements across claims procedures and training.
Responsibilities
The purpose of this job is to develop audit schedules based on best practices for procedural claims audits using various sampling methods
Performs procedural claims audits based on various sampling methods
Provides analysis and improvement planning based on audit results
Conducts double reviews to ensure continuous calibration and consistent understanding and adherence to claims best practices
Analyzes quality issues and provides feedback to stakeholders
Develops audit schedules for the department
Develops questionnaires and manages assessments for internal audit tools
Oversees and prepares responses to all audits, whether internal or external
Develop workflows and implement training for technical and non-technical employees to ensure operational integrity
Plans, develops, and provides ongoing technical training and staff development programs
Updates the claims procedures accordingly on the department’s SharePoint site
Provides performance and skill assessments to managers and supervisors on an ongoing basis
Collaborates with multiple employees on auditing, training and customer service issues for the department
Partners with leadership to ensure service and quality levels are within standard operating procedures for the department.
Requirements
High school diploma or General Education Degree (GED), required
Bachelor's degree preferred
Minimum 6 years of technical claims handling experience is required
Prior audit experience is highly desirable
Benefits
We offer a competitive benefits package, with generous medical, dental, and vision plans as well as 401K retirement plans and company match
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