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Internal Auditor

Company:
ATR International
Location:
Englewood, Colorado, 80112, United States
Posted:
July 13, 2018
Description:

Job Title: Internal Auditor

Job Location: Englewood, CO

Job Duration: 3 months

Job Description:

We are seeking an Internal Auditor for a very important client.

Major Responsibilities:

- Responsible for conducting audit testing and completing documentation of the work performed for audit in diverse disciplines.

- Develop work papers that address the objectives of the audit program and support the conclusions reached during testing. Adhere to the IIA Standards and IAS guidelines for workpaper documentation.

- Assess business systems/processes to identify key control points and risks.

- Document using narrative and/or flowcharting techniques.

- Draft audit conclusions, discuss potential issues with clients, and prepare and deliver other summary communication documents

- Support the assigned practice area team.

- Develop and maintains good working relationships

- Other duties as assigned.

Job Criteria:

- Has the ability to function both independently & as a team member.

- Ensures compliance with functional policies and procedures prescribed by management.

- Interprets and carries out general guidelines.

- Requires some judgment to consider alternatives.

- Develops solutions to a variety of problems of moderate scope and complexity using judgment within defined practices and procedures.

- Assesses information to identify the best solution from existing alternatives.

- Interacts regularly with various Regional management, Internal Audit management & staff, external auditors & consultants.

- Typically receives general direction on routine work and detailed direction on new assignments.

- Exercises judgment within defined procedures and practices to determine appropriate action.

Top Daily Responsibilities:

1. Conduct quality assurance audits for all lines of business. Access the mainframe system to review each claim image to the actual data input into the system & claim payment to ensure accuracy. Benefits, coverage, eligibility are all verified.

2. Conduct quality assurance audits adjustments, refunds & provider disputes. Review each claim image to the actual data input into the system & claim payment to ensure accuracy.

3. The position requires research, problem resolution & specialized knowledge in the areas of contracts, Medicare & Medi-Cal regulations & reimbursement rules, Multiplan & Beechstreet, Worker's Compensation, Coordination of Benefits & Third Party liability.

Requirement:

The ideal candidate will possess the following qualifications:

Requirements:

- Typically less than one year of auditing or comparable experience. More experienced staff in this position considered to have 2 years of experience.

- General accounting, financial & business skills, knowledge, & experience.

- Ability to adapt quickly to changing demands & environment, & rapidly develop in-depth knowledge of new audit areas.

- Ability to effectively utilize general audit software such as ACL, TeamMate, etc.

- Basic project management skills.

- Excellent verbal & written communication & presentation skills.

- Microsoft Office (Word, Excel, PowerPoint & Access)

- Lotus Notes

- Sets the tone for ethical behavior, actively models ethical behavior to set an example for others.

- Identifies ethical issues and discusses them in a timely and constructive manner to obtain a rapid and effective resolution.

- Does not tolerate a breach of ethics in others.

Education:

- Bachelor's degree in business, accounting, finance, information systems or related field or equivalent experience required.

License/Certification:

Actively pursuing 1 of the following:

- Certified Internal Auditor (CIA)

- Certified Public Accountant (CPA)

- Certified Information System Auditor (CISA)

- Minimum three (3) years of claims processing with minimum two (2) years of claims auditing experience.

- Bachelor's degree in related field, OR four (4) years of experience in a directly related field.

- High School Diploma or General Education Development (GED) required.

Skills a Top Candidate Should Have:

1. The auditor must be thoroughly familiar w/ outside medical systems & claims processing/adjudication processes.

2. The Auditor must independently perform comprehensive audits of claims to source documents & identify inaccuracies.

3. The auditor must also be capable of developing a working relationship w/ regulatory agencies.

4. Intermediate competency in MS Applications (Excel, Access, PowerPoint), outstanding ability with proprietary and mainframe processing systems COMPANY technologies.

5. Discusses the roles and responsibilities of major business units and department's operating principles and practices.

Desired Skills:

1. Exercises judgment w/in defined procedures & practices to determine appropriate action. At times the documented process may not be clear or even be conflicting, the Auditor must research the correct process & base their audit on the best practice which may not always be the documented process.

2. Uses professional concepts & company policies & procedures to solve a wide range of difficult problems in imaginative & practical ways.

3. Builds productive working relationships internally & externally. Auditors work closely w/ various CCA departments such as Operations, Training & Compliance to ensure lines of communication are kept open w/ processing or auditing related issues.