Audit Associate

Job Description Serves as audit coordinator and/or representative for broader departmental audits, including annual audits, control audits, and focused audits due to special business requests. Determines what information is needed for the audit and coordinates the information gathering process for the department. Using information obtained from audits, determines root cause of specific issues and formulates tactical recommendations for quality and process improvements.

Supports the implementation of necessary remediation strategies as needed.

Coordinates and conducts broader departmental audits to determine accuracy and efficiency of established process and procedures, i.e. FRRM, SSAE-16, Financial Year End, HEDIS, PG & MTM audits, government contractually required audits, etc. This may also include self testing and risk and control assessments. Partners effectively with Internal Audit and assists external auditors when on site to complete various recurring or required audits.

Assesses information obtained through interviews, observation and inspection to identify complex patterns of error trends, determine root causes and communicate any potential compliance or operational risk issues to management. Formulates tactical recommendations for quality/process improvements and solutions to mitigate risk and control deficiencies identified through specific audits. Follows through after implementation of remediation strategies to ensure that quality improvement gains are maintained.

Attends and/or presents at team meetings to keep all staff informed of audit activities, issues and decisions and advise on risk/control matters. Serves as technical resource for the department and provides assistance with resolution of customer issues related to exceptions from audits, system issues, training, and coaching/feedback at the team or department level to address insidious errors and/or gaps. Partners with the business area(s) to ensure procedures are current and may participate in the development and revision of business processes and procedures as needed.

Serves as departmental representative on applicable project teams as needed.

• Bachelor's degree or advanced degree (where required)
• 0-2 years of experience in related field.
• In lieu of degree, 3+ years of experience in related field.
• Bonus Points Previous experience working with Federal Employee Program (FEP) claims processing, administration, or support.

• The opportunity to work at the cutting edgeof health care delivery with a teamthat’sdeeply invested in the community
• Work-life balance, flexibility, and the autonomy to dogreat work
• Medical, dental, and vision coverage along withnumeroushealth and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution

Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused. In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

At Blue Cross NC, we take great pride in a fair and equitable…