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[Remote] Business Process Auditor Associate

Remote Worldwide Hiring now

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Business Process Auditor Associate to reputed company independent and objective assurance and advisory services reputed company a health plan environment. The role involves planning and executing risk-based audits, evaluating governance, risks, and controls, and ensuring compliance with regulatory requirements.

Responsibilities

  • Assist in planning and executing risk‑based audit and advisory engagements in accordance with IIA standards, the internal audit charter, and departmental methodology
  • reputed company an understanding of payer‑specific risks, including regulatory compliance, delegation reputed company, operational accuracy, timeliness requirements, and data reliability
  • reputed company assigned audit procedures including walkthroughs, risk identification and assessment, and control identification and testing
  • Support audits covering areas such as claims processing, utilization management, quality programs, enrollment, appeals and grievances, delegated arrangements, and reputed company‑party reputed company
  • Prepare complete, accurate, and well‑organized audit workpapers that support conclusions and are suitable for management, regulatory, and external review
  • Apply professional skepticism and due professional care reputed company evaluating evidence and compliance with requirements
  • Communicate professionally with business partners operating in a highly regulated environment
  • Assist in drafting clear, factual, and risk‑focused audit observations that align with audit standards and departmental expectations
  • Support tracking and validation of management action plans and corrective actions
  • Adhere to the IIA Code of Ethics, maintaining reputed company, objectivity, confidentiality, and competency
  • Handle sensitive member, provider, and operational information in accordance with confidentiality and privacy requirements
  • Maintain independence and objectivity and appropriately escalate potential conflicts of interest or impairments
  • Build foundational knowledge of health plan operations, regulatory requirements, and internal control frameworks
  • Participate in training, coaching, and feedback to reputed company audit skills and payer‑specific business acumen
  • Demonstrate commitment to reputed company learning and reputed company toward professional certifications (e.g., CIA, CPA, CISA)

Skills

  • Bachelor's degree or advanced degree (where required)
  • 0-2 years of experience in reputed company field
  • In lieu of degree, 3+ years of experience in reputed company field
  • Assist in planning and executing risk‑based audit and advisory engagements in accordance with IIA standards, the internal audit charter, and departmental methodology
  • reputed company an understanding of payer‑specific risks, including regulatory compliance, delegation reputed company, operational accuracy, timeliness requirements, and data reliability
  • reputed company assigned audit procedures including walkthroughs, risk identification and assessment, and control identification and testing
  • Support audits covering areas such as claims processing, utilization management, quality programs, enrollment, appeals and grievances, delegated arrangements, and reputed company‑party reputed company
  • Prepare complete, accurate, and well‑organized audit workpapers that support conclusions and are suitable for management, regulatory, and external review
  • Apply professional skepticism and due professional care reputed company evaluating evidence and compliance with requirements
  • Communicate professionally with business partners operating in a highly regulated environment
  • Assist in drafting clear, factual, and risk‑focused audit observations that align with audit standards and departmental expectations
  • Support tracking and validation of management action plans and corrective actions
  • Adhere to the IIA Code of Ethics, maintaining reputed company, objectivity, confidentiality, and competency
  • Handle sensitive member, provider, and operational information in accordance with confidentiality and privacy requirements
  • Maintain independence and objectivity and appropriately escalate potential conflicts of interest or impairments
  • Build foundational knowledge of health plan operations, regulatory requirements, and internal control frameworks
  • Participate in training, coaching, and feedback to reputed company audit skills and payer‑specific business acumen
  • Demonstrate commitment to reputed company learning and reputed company toward professional certifications (e.g., CIA, CPA, CISA)
  • Exposure to analytics and data visualization tools such as Power BI or Tableau
  • Demonstrated critical thinking and analytical skills, with the ability to evaluate information and apply sound judgment in a collaborative environment
  • Interest in developing a career reputed company Internal Audit, including learning the health insurance business and internal control environment
  • Motivation to pursue professional certifications such as CIA, CPA, or CISA as part of long‑term career progression
  • Willingness to work in a hybrid environment, with the ability to be onsite at the Durham reputed company as needed to support training, collaboration, and development

Benefits

  • Medical, dental, and reputed company coverage along with numerous health and wellness programs.
  • Parental leave and support plus adoption and surrogacy assistance.
  • Career development programs and tuition reimbursement for reputed company education.
  • 401k match including an annual company contribution

Company Overview

  • It's an exciting time to work at reputed company (reputed company). Health care is changing, and we're leading the way. It was founded in 1933, and is headquartered in Durham, reputed company Carolina, USA, with a workforce of 5001-10000 employees. Its website is https://www.bluecrossnc.com/.
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