Anthem, Inc. Compliance Audit Specialist in Hialeah Gardens, Florida
SHIFT: Day Job
Compliance Audit Specialist
This position will reside in Florida with Tampa, FL preferred.
Responsible for ensuring program integrity by establishing an audit process that is efficient and effective in monitoring operations, and compliance with Federal, State laws and regulations, CMS, OIG, as well as contractual obligations.
Primary duties may include, but are not limited to:
Performs audits to ensure the fundamental systems of internal controls are in place and functioning; general business controls of, but not limited to, Claims and Call Center Operations, Accounting & Reporting, Information & Technology, Financial, Human Resources, Training and Compliance Program Integrity.
Assist management in identification and analysis of relevant risks to achieving predetermined business objectives.
Assist in developing and refining the Corporate Risk Matrix report.
Provides technical support and other consulting activities to those departments within the MBU regarding compliance and audit recommendations.
Prepares appropriate written audit findings and recommendations for approval by the audit management team.
Requires BA/BS degree, 2 years related experience; or any combination of education and experience, which would provide an equivalent background.
National Association coding certification, national association compliance certification and/or national association auditor certification preferred.
Minimal travel may be required.
Medicare experience is preferred.
Operational experience is preferred.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.