Performance Auditor II

Location US-IA-Des Moines
Job ID
212847
Category
Internal Audit
Requires Non-Compete?
No

Job Summary

Wellmark is currently recruiting for a Performance Auditor II to join our team! This individual will perform intermediate-to-complex level operational audits of core business processes, including claims payment, member benefits and enrollment, customer service inquiries, and provider contracts. You must apply knowledge, skill, and experience over a broad range of financially and operationally significant corporate operations and relates business transaction processing functions.

Minimum Qualifications Required (all must be met to be considered)

  • Bachelor’s Degree in Accounting or related field
  • Minimum 1 year of internal or external Audit experience
  • Proven analytical skills, with the ability to analyze data and make recommendations
  • Strong communication skills, both verbal and written
  • Demonstrated interpersonal skills with the ability to build and develop collaborative relationships of trust
  • Strong attention to detail with the ability to complete tasks accurately and completely
  • Flexible and adaptable to change with the ability to guide others through it

Hiring Specifications Preferred

  • Bachelor’s Degree in Accounting
  • 2-3 years of auditing experience
  • Prior experience in the insurance industry
  • Professional Certification - e.g., Certified Public Accountant (CPA), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE)
  • Prior experience using analytic and reporting tools, including Business Objects and SAS EG

Job Accountabilities

a. Performs intermediate to complex level operational audits using statistical sampling methodologies, including coverage of core business transactions such as claims, membership & enrollment, and customer service.

b. Coordinates multiple audit projects , including issue identification and coordination of corrective action plans in accordance with regulatory and Blue Cross Blue Shield Association BCBSA guidance.

c. Compiles and reviews populations of transactional data against established parameters for accuracy and completeness. Develops and documents samples to be audited in accordance with audit requirements.

d. Compiles and maintains audit documentation in appropriate files, databases, and systems to support audit work performed, conclusions/issues identified, and recommendations/action plans. Maintains desk level procedures for assigned audits.

e. Identifies and assesses risks and controls and tests controls for WellSOX program to ensure controls are working effectively.

f. Provides assistance to external auditors during their interim and/or yearend audit financial and for the SOC audit.

g. Maintains and continually improves understanding of Wellmark's business and business environment including compliance with laws and regulations, new products and services offered by Wellmark, organizational structure, corporate policies, and Wellmark's strategic direction.

h. Collaborates with fraud investigation unit in the performance of fraud investigations, including data compilation and analysis, application of fraud investigation techniques, and reporting of conclusions and results.

i. Abides by the Standards for the Professional Practice of Internal Auditing.

j. Other duties as assigned.

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