Talent.com
Auditor III, Medicare
Auditor III, MedicareBlueCross BlueShield of South Carolina • Baltimore, MD, United States
Auditor III, Medicare

Auditor III, Medicare

BlueCross BlueShield of South Carolina • Baltimore, MD, United States
Hace 19 horas
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Internal Reference Number : R1047647

Summary Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources.Description 50% Conducts internal and / or external timely operational, financial, and / or compliance audits of divisions, departments, providers, and activities of the corporation including evaluation of internal controls. Identifies, documents, and evaluates business risks. Develops written audit programs. Conducts testing and analysis of existing controls to determine adequacy and effectiveness. Prepares written work papers to document testing results and conclusions reached. Documents issues, the causes of those issues, and their effects on the process / function and the corporation. Serves as Lead Auditor on more complex audit assignments.

15% Drafts recommendations to limit risks and improve processes, functions and activities. Writes audit reports for corporate executive management that clearly and effectively convey engagement evaluations, conclusions and recommendations. Collects and analyzes data to detect deficient controls, duplicated effort, fraud, or non-compliance with laws, regulations, and management policies. Conducts testing of corrective actions as identified.

10% Develops detailed reports on each audit conducted. Reports include a review of findings and an identification of recommendation to correct any deficiencies and methods for improvement to processes. Examine and evaluate financial and information systems, recommending controls to ensure system reliability and data integrity.

10% Conducts special audit studies for management, such as those required to discover controls for prevention of fraud. Prepares reports of findings and recommendations for management.

10% Provides training to and assists or leads other auditors in completing their assignments as a means of maximizing audit efficiency and thus reducing lost time and involvement of corporate personnel.

5% Strives to expand knowledge of applicable laws, regulations, program instructions, and technology through self-study, corporate offerings, and formal training programs.

Required Education : Bachelor's in a job related field.

Required Experience : 5 years auditing experience.

Required Skills and Abilities : Knowledge of the principles and practices of auditing. Ability to analyze and determine the applicability of financial data, to draw conclusions and make appropriate recommendations. Ability to gather information by examining records and documents and to interview individuals concerning those records. Strong interpersonal skills and the ability to work professionally with persons at all levels, and to maintain effective working relationships. Ability to communicate clearly and effectively in oral and written form. Ability to handle sensitive matters on a confidential basis. Excellent analytical or critical thinking and problem solving capabilities.

Required Software and Tools : Microsoft Office.

Preferred Education : Bachelor's degree- any major

Preferred Licenses and Certificates : Certified Internal Auditor (CIA), Certified Public Accountant (CPA), or Certified Information Systems Auditor (CISA)

Work Environment : Typical office environment. Travel between office buildings and out of town may be required.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

Some states have required notifications. Here's more information.

Crear una alerta de empleo para esta búsqueda

Auditor Iii • Baltimore, MD, United States

Ofertas relacionadas
Inpatient Audit Specialist

Inpatient Audit Specialist

VirtualVocations • Rockville, Maryland, United States
A tiempo completo
A company is looking for an Inpatient Audit Specialist to conduct coding audits and provide education related to coding quality and compliance. Key Responsibilities Conduct inpatient coding audits...Mostrar más
Última actualización: hace más de 30 días
Insurance Claims Environmental

Insurance Claims Environmental

Diedre Moire Corp. • Annapolis, MD, US
A tiempo completo
Pollution & Health Hazard Claims Specialist - Annapolis, MD Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard _.REMOTE WORK FR...Mostrar más
Última actualización: hace 4 días • Oferta promocionada
Remote Claims Representative

Remote Claims Representative

Metro Public Adjustment • Baltimore, MD, US
Teletrabajo
A tiempo completo +1
Benefit from our 31 years of experience in business : We have an AWESOME training program and it's FREE!! Part time $35,000 or full time $150,000 based on what you do (COMMISSION) Looking to fill Ma...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Patient Accounts Specialist

Patient Accounts Specialist

Greater Baltimore Medical Center (GBMC) • Lutherville-Timonium, MD, United States
A tiempo completo
Under direct supervision, performs all collection functions on account balances within assigned financial classes.Those on the collections / self-pay team will also be required to serve as a represen...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Patient Accounting Solution Advisor

Patient Accounting Solution Advisor

Axelon Services Corporation • Arnold, MD, US
A tiempo completo
Title : Patient Accounting Solution Advisor.Client is seeking a Patient Accounting Solution Advisor to support the Department of Veterans Affairs (VA) Electronic Health Record Modernization (EHRM) p...Mostrar más
Última actualización: hace 1 día • Oferta promocionada
Senior Contracting Compliance Analyst - Professional Billing - Mount Sinai Health Partners

Senior Contracting Compliance Analyst - Professional Billing - Mount Sinai Health Partners

Mount Sinai Hospital • Washington, DC, US
A tiempo completo
Mount Sinai is one of the largest U.We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. We are accelerating a trans...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Claims Consultant

Claims Consultant

Pop-Up Talent • Bethesda, MD, US
A tiempo completo
The Claims Consultant will be responsible for conducting impact analysis, analyzing risk on complex projects, and performing forensic schedule and cost analysis consisting of identifying critical p...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Accountant at Radiocw-Healthcare

Accountant at Radiocw-Healthcare

Radiocw-Healthcare Maryland • Olney, MD, US
A tiempo completo
Radiocw Healthcare in Gaithersburg, MD is looking for one accountant to join our team.We are located on 9020 Bramble Bush Ct. Our ideal candidate is a self-starter, ambitious, and engaged.Ensure pro...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Field Reimbursement Specialist

Field Reimbursement Specialist

AmerisourceBergen Corporation (Cencora) • Washington, DC, United States
A tiempo completo
Our team members are at the heart of everything we do.At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on ...Mostrar más
Última actualización: hace 11 días • Oferta promocionada
Claims Analyst

Claims Analyst

ARMADACARE • Lutherville-Timonium, MD, US
A tiempo completo
Armada - pay our members claims! The Claims Analyst is responsible for reviewing portal entry claims, conducting error correction and quality control reviews, as well as final adjudication of paper...Mostrar más
Última actualización: hace 29 días • Oferta promocionada
Inpatient Audit Specialist

Inpatient Audit Specialist

Datavant • Annapolis, MD, United States
A tiempo completo +1
Datavant is a data platform company and the world's leader in health data exchange.Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format....Mostrar más
Última actualización: hace 1 día • Oferta promocionada
HIM CODING COMPLIANCE AUDITOR

HIM CODING COMPLIANCE AUDITOR

LifeBridge Health • Baltimore, MD, United States
A tiempo completo
HIM CODING COMPLIANCE AUDITOR .Department" aria-hidden="true"> .Schedule - Shift - Hours" aria-hidden="true"> .Full-time - Day shift - 7 : 30am-4 : 00pm . Job Category" aria-hidden="true"> .S...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Insurance Verification Specialist

Insurance Verification Specialist

TEKsystems • Baltimore, MD, US
A tiempo completo
You will be verifying insurance coverage and benefits utilizing all available verification and eligibility tools and calls payers to collect more information. You will also obtains the necessary ref...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Billing Specialist-MSH-78319-030

Billing Specialist-MSH-78319-030

Mount Sinai Hospital • Washington, DC, US
A tiempo completo
Focus on the core content of the job post, removing all extra metadata, navigation, and redundant headers.The job title and description are the main focus, presented in a clean and beautiful format.Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Claims Analyst

Claims Analyst

Edenbridge Health Llc • Washington, DC, US
A tiempo completo
Organization : Edenbridge PACE at Skyland.Mission : To allow frail elderly people to age in the location of their choosing and continue to lead connected, meaningful lives. The Claims Analyst reviews,...Mostrar más
Última actualización: hace 3 días • Oferta promocionada
Outpatient Audit Specialist

Outpatient Audit Specialist

Datavant • Annapolis, MD, United States
A tiempo completo
Datavant is a data platform company and the world's leader in health data exchange.Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format....Mostrar más
Última actualización: hace 1 día • Oferta promocionada
Claims Analyst I

Claims Analyst I

Healthcare Legal Solutions LLC • Washington, DC, US
A tiempo completo
This position is responsible for assisting with following up on administrative appeals and documentation submitted to health insurers and governmental payers. working well with attorneys and parale...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada
Reimbursement Specialist I - Sunburst

Reimbursement Specialist I - Sunburst

Amergis Healthcare Staffing • Columbia, MD, US
A tiempo completo
The Reimbursement Specialist I Sunburst reviews Sunburst sales for appropriate documentation, generates and bills claims and / or invoices, follows up on unpaid accounts, and provides support and cu...Mostrar más
Última actualización: hace más de 30 días • Oferta promocionada