Senior External Audit Specialist

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🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $75.4k - $140k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Capital Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1938

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.

📋 Description

• Plan, organize, and lead external audit projects related to group benefit examinations, group audits, BCBSA audits, and contractual compliance reviews • Act as primary liaison between external auditors and Capital operational areas • Track and manage audit deliverables, ensuring timely completion and accurate documentation • Provide training to internal parties supporting external auditors and reviewing audit exceptions • Recommend and develop department policies and procedures • Ensure Capital meets contractual obligations related to group audit rights and compliance clauses • Review proposed changes to contractual audit rights with Legal and advise Sales and Underwriting Management • Maintain collaborative relationships with external auditors and ensure adherence to Capital standards • Lead audit-related meetings, including with senior leadership • Provide guidance on Capital processes and organizational structure • Oversee, coordinate, and schedule external audits, examinations, and surveys • Maintain an external audit schedule, collect requested documentation, and ensure timely, professional responses • Monitor audit items, assign tasks, and ensure timely follow-up • Recommend corrective actions and verify implementation through performance tracking • Communicate audit progress and compliance risks to Capital leadership • Prepare and present reports for management review

🎯 Requirements

• 5 years' experience in compliance/audit • Project management experience required • Bachelor’s degree in accounting, finance, business, or data analytics, or the equivalent of 8 or more years in project management and/or audit experience required • Advanced degree preferred • Certifications preferred: Certified Quality Auditor (CQA), Certified Internal Auditor (CIA), Certified Information Systems Auditor (CISA), Certified Public Accountant (CPA), Certified Risk Management Assurance (CRMA), Certified Analytics Professional (CAP) • Deep understanding of Capital systems and processes • Strong negotiation skills • Proficiency in Microsoft Office Suite and audit tracking tools • Analytical and problem-solving skills • Exceptional organizational and project management skills • Knowledge of Capital commercial, ancillary, and government product lines and supporting operations • Working knowledge of sales, marketing, enrollment, billing, underwriting, configuration, IT, claims, customer service, clinical management, government programs, internal audit, and finance processes, preferably in the health insurance industry • Familiarity with MARIS, Salesforce, and FACETS • Ability to communicate effectively across all organizational levels • Ability to establish and maintain cooperative professional relationships • Ability to adjust to changing priorities and meet urgent deadlines

🏖️ Benefits

• Medical, Dental & Vision coverage • Retirement Plan • Paid Time Off • Holidays • Volunteer time off • Incentive Plan • Tuition Reimbursement • Flexible environment • Training and continuing education • Community volunteering opportunities

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