Plan, organize, and lead external audit projects related to group benefit examinations and contractual compliance reviews.
Serve as primary liaison between external auditors and internal business units, ensuring timely completion and accurate documentation of audit deliverables.
Monitor open audit items, assign tasks, and provide leadership to ensure compliance with organizational processes and standards.
Capital Blue Cross is a health insurance company that provides coverage and wellness services to its members. The company is consistently voted one of the Best Places to Work in PA, and its culture emphasizes flexibility, support, and community involvement.
Coordinate and complete payer audits per program requirements and deadlines.
Review claims for accuracy, identify discrepancies, investigate root causes, and report findings.
Maintain up-to-date knowledge of billing regulations and support training and process improvements.
CarepathRx provides healthcare pharmacy services with a focus on home infusion and revenue cycle operations. The company emphasizes operational excellence, accuracy, and a remote work culture supporting employee success.
Lead complex Workers' Compensation audits, including multi-state and test-state audits.
Investigate disputes, apply state-specific rules, and ensure regulatory compliance.
Collaborate with teammates and improve audit processes and accuracy.
ERGO NEXT is a technology-led, full-stack provider of small business insurance, transforming the customer experience for entrepreneurs. Since 2016, they've helped hundreds of thousands of small business customers and are backed by industry leaders, with a culture of teamwork and inclusion.
Conduct compliance audits across a nationwide network of nonprofit chapters to assess policy adherence.
Analyze audit results, document findings, and recommend corrective actions to address identified gaps.
Build trusted relationships with chapter teams and leadership while supporting broader risk management initiatives.
The company is a mission-driven nonprofit organization with a nationwide network of chapters. It focuses on creating meaningful experiences and positive outcomes for children and families, fostering a collaborative and detail-oriented culture.
Conducts audits of chapter compliance with Make-A-Wish policies and procedures, summarizing findings and recommending corrective actions.
Partners with chapters as a trusted compliance advisor, providing feedback, education, and follow-up on audit findings.
Supports enterprise risk management efforts and performs additional compliance projects and reports as needed.
Make-A-Wish is the world's largest wish-granting organization, uniting communities to grant life-changing wishes for eligible children. The organization fosters a supportive, mission-driven culture that embraces wish families, volunteers, and colleagues.
Conduct real-time audit file examinations for underwriters to ensure compliance with company underwriting standards.
Identify and report errors, inconsistencies, and deficient underwriting to management for further review.
Perform quality control reviews, post-issue APS reviews, and ad hoc audits to preserve pricing integrity.
Banner Life Insurance Company provides life insurance and underwriting solutions, committed to serving customers, clients, and communities long-term. We are a forward-thinking company with a culture built on meaningful impact, professional development, and wellbeing, where our people drive innovation and collaboration.