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 30x5 (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
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