Senior Medicare Compliance Auditor
The ideal candidate for the Sr. Medicare Compliance Auditor will be an excellent communicator (written and verbal) who is detail oriented, organized, able to read and interpret regulations, able to meet tight deadlines while handling multiple audits. He/she will also be able to work independently and with a team, demonstrating self-motivation and enthusiasm.
Responsibilities include:
- Auditing Medicare Advantage and Part D operations and processes: analyzing data, reviewing Policies and Procedures, documenting work and drafting audit reports.
- Working with the leadership of the operational departments to ensure corrective action plans are in place and management actions plans are completed.
- Managing and coordinating audits by regulators
- Reviewing the implementation of new or changed regulatory requirements to help ensure the adequacy of controls.
- Providing guidance and subject matter expertise to operational staff.
- Ensuring the Medicare Compliance Program is effective and maintaining Medicare Compliance department documentation.
- Maintaining all organization and professional ethical standards.
- Bachelor’s degree or equivalent experience required.
- CPA preferred, Experience in a Big Four Firm preferred.
- Experience with data analytics, operational auditing or claims auditing strongly desired.
- Experience in auditing regulatory requirements is desired.
- Knowledge of Medicare Advantage and Medicare Prescription Drug Programs operations and regulations is preferred.
- Proficiency in the use of Microsoft Office (Word, Excel) required.
Diversity, Equity, and Inclusion
At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
Vaccination Update
This job requires that you demonstrate you have been fully vaccinated for COVID-19 prior to the start of employment, to the extent permitted by law.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.