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About the Role

This role provides a leadership position in monitoring, analyzing, and auditing complex financial transactions, evaluating regulatory compliance, developing corrective actions, and delivering training. It also involves acting as a consultant on audit activities, developing programs to prevent abuse, and leading projects, with frequent interaction with staff and management at various levels.

Responsibilities

• Monitor, analyze, and evaluate assigned financial/accounting transactions and other financial data for accuracy, propriety, and compliance with policy requirements.
• Document and summarize activities and results in analyses and reports to department management.
• Lead approximately three to five financial audits/reviews per year (via desk or on-site) to determine the accuracy and propriety of Plans recorded financial transactions/reports and assess compliance with pertinent Policies.
• Supervise and train team members assigned to support these audits.
• Evaluate the level of compliance with applicable federal regulations, contractual requirements, and procedures at BCBSA and Plans.
• Maintain the BCBSA compliance plan and serve as the main point of contact for BCBSA and Plans financial and claims audits.
• Develop corrective action plans as needed.
• Serve as subject matter expert for BCBSA financial policies and procedures regarding the audit process.
• Instruct audit flow facilitation.
• Analyze and assess audit trends, best practices, and risk.
• Develop an overall and effective audit program.
• Develop and present training to BCBSA and Plans as it relates to all types of audits.
• Evaluate Plan inter-Plan billing rate requests of high complexity levels and recommend rates to be approved to ensure billings/reimbursements between Plans are valid and for proper amounts.
• Perform more complex activities relating to administration of the contract with a large banking institution.
• Provide guidance to team members on their assignments.
• Ensure that BCBSA’s transaction billings to Plans are correct.
• Ensure that the various transaction activity reports provided to the Plans meet their internal needs.

Requirements

• Minimum of five years of related work experience, including health insurance accounting, internal/financial auditing, general accounting, financial reporting, and project management.
• Experience with BCBS Inter-Plan Programs.
• Proficiency with Microsoft Office Suite.

Skills

• Effective written and verbal communication skills.
• Demonstrated ability to build relationships with key resource people, whether internal or external.
• Ability to train less experienced staff.
• Advanced analytical skills and ability to frame issues and develop solutions.
• Ability to work independently and manage time effectively.
• Effective presentation skills and ability to adapt to changing priorities.
• Intermediate knowledge of auditing, finance, and claims operations.
• Advanced negotiation, analytical, and problem-solving skills.
• Effective project management, interpersonal, and organizational skills.
• Ability to develop and maintain business relationships and create strategies that support initiatives.

Location

• Remote

Work Type

• Remote
• Full-time

Experience Level

• 5+ Years related work experience

Education Level

• Bachelor's Degree in accounting, business, finance, or related field; or equivalent work experience

Salary/Compensations

• 92,787.88 - 122,529.02

Benefits

• Paid time off
• 11 holidays
• Medical/dental/vision insurance
• Generous 401(k) matching
• Lifestyle spending account
• Annual bonus incentive pay