Internal Auditor
Corporate-CO, Miami, Florida, 33166, United States
About the Role
We are seeking a detail-oriented and analytical Internal Auditor to join our team and perform audits across multiple operational areas, including health plan claims operations, finance, compliance, clinical services, and IT. This role is critical in ensuring enterprise-wide compliance, operational efficiency, and strong internal controls. The Internal Auditor will conduct independent reviews, assess risks, and provide actionable recommendations to strengthen processes and mitigate potential issues.
Key Responsibilities
- Develop and execute risk-based audit plans covering multiple operational areas (claims, finance, compliance, clinical, IT).
- Evaluate internal controls related to health plan claims, financial reporting, regulatory compliance, and operational processes.
- Perform audits to identify control gaps, operational inefficiencies, and potential fraud risks across departments.
- Review adherence to company policies, procedures, and industry best practices.
- Prepare comprehensive audit reports detailing findings, recommendations, and corrective actions.
- Collaborate with leadership teams across departments to implement improvements.
- Monitor remediation efforts and follow up on audit recommendations.
- Maintain documentation in accordance with professional auditing standards (IIA).
Qualifications
- Bachelor’s degree in Accounting, Finance, Business Administration, or related field.
- 3–5 years of internal audit experience, preferably in healthcare or managed care.
- Strong understanding of health plan operations and claims processing.
- Knowledge of regulatory requirements (Medicare, Medicaid, CMS guidelines).
- Excellent analytical, problem-solving, and communication skills.
- Proficiency in audit tools and Microsoft Office Suite.
- Preferred: CIA, CISA, or healthcare compliance certifications.
Skills & Competencies
- Strong attention to detail and ability to work independently.
- Ability to manage multiple audits and meet deadlines.
- Effective collaboration and relationship-building skills.
- High ethical standards and commitment to confidentiality.
Reporting Structure
Reports to: Chief Financial Officer