Operations Compliance Auditor

Operations Auditor
Join our team as an Operations Auditor and play a key role in strengthening processes, ensuring compliance, and driving continuous improvement across the business. In this role, you'll evaluate operational practices, identify risks and inefficiencies, and partner with leaders to implement practical, value-added solutions. We're looking for a detail-oriented professional who thrives on data analysis, problem solving, and influencing positive change. Apply today and help shape smarter, more efficient operations.
Independently conduct comprehensive audits to evaluate accuracy and compliance of various internal processes throughout the company as determined on a needs basis, a random rotational basis or to satisfy corporate reporting metrics.
Conduct prescribed audits of claims processing accuracy to support the monitoring of performance standards.

• Perform defined audits of other operational processes to meet internal oversight, departmental and business objectives.
• Complete ad hoc audits, as needed.
• Evaluate audit results against internal processes and/or controls to identify areas of non-compliance and improvement opportunities; considering compliance with prescribed operational processing guidelines, policies, state and federal laws, executed contracts and DDPA requirements, as applicable.
• Clearly document identified audit findings in a timely manner for monitoring and escalation.
• Maintain files in accordance with management policies and guidelines by obtaining and attaching all appropriate documentation to clearly establish an audit trail for each audit performed.
• Maintain confidentiality of company policies and procedures, audit results, and information about clients, members, providers, and employees.
• High school diploma required. Prefer three years of experience in operations auditing, or the health insurance industry to demonstrate a functional knowledge of insurance operations.
• Able to work independently without close supervision.
• Demonstrate integrity and honesty in all aspects of job performance.
• Working knowledge of Microsoft Office, including proficiency in Word, Excel and Outlook.
• Demonstrated commitment to the company's core values of integrity, adaptability, service-focused, accountability, curiosity, and community.

General office working conditions which may require sitting for extended periods of time
Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
The employee is frequently required to use hands and arms to handle, feel and reach as well as operate a personal computer.