Senior External Audit Specialist

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Plan, organize, and manage external audit projects pertaining to group benefit examinations, group audits, BCBSA audits, and compliance reviews.

• Serve as the main point of contact between external auditors and Capital's operational divisions.

• Monitor and manage audit deliverables, ensuring they are completed on time and documented accurately.

• Provide training for internal teams that support external auditors and review audit exceptions.

• Propose and develop policies and procedures for the department.

• Ensure that Capital adheres to contractual obligations regarding group audit rights and compliance clauses.

• Review proposed modifications to contractual audit rights in coordination with Legal, and provide advice to Sales and Underwriting Management.

• Foster collaborative relationships with external auditors while ensuring compliance with Capital’s standards.

• Lead audit-related meetings, including those with senior leadership.

• Offer guidance on Capital’s processes and organizational structure.

• Oversee, coordinate, and schedule external audits, examinations, and surveys.

• Keep an updated external audit schedule, gather necessary documentation, and ensure timely, professional responses.

• Track audit items, delegate tasks, and ensure timely follow-ups.

• Suggest corrective actions and confirm their implementation through performance monitoring.

• Report on audit progress and compliance risks to Capital leadership.

• Prepare and deliver reports for management review.

⛳️ Requirements

• A minimum of 5 years of experience in compliance/audit.

• Experience in project management is required.

• A Bachelor’s degree in accounting, finance, business, or data analytics, or equivalent to 8 or more years of project management and/or audit experience is required.

• An advanced degree is preferred.

• Preferred certifications include Certified Quality Auditor (CQA), Certified Internal Auditor (CIA), Certified Information Systems Auditor (CISA), Certified Public Accountant (CPA), Certified Risk Management Assurance (CRMA), and Certified Analytics Professional (CAP).

• In-depth knowledge of Capital systems and processes.

• Strong negotiation abilities.

• Proficient in Microsoft Office Suite and audit tracking tools.

• Excellent analytical and problem-solving skills.

• Outstanding organizational and project management skills.

• Familiarity with Capital’s commercial, ancillary, and government product lines and their supporting operations.

• Working knowledge of sales, marketing, enrollment, billing, underwriting, configuration, IT, claims, customer service, clinical management, government programs, internal audit, and finance processes, ideally within the health insurance sector.

• Familiarity with MARIS, Salesforce, and FACETS.

• Ability to communicate effectively at all organizational levels.

• Capacity to establish and maintain collaborative professional relationships.

• Flexibility to adapt to changing priorities and meet tight deadlines.

🏝️ Benefits

• Medical, Dental & Vision coverage.

• Retirement Plan.

• Paid Time Off.

• Holidays.

• Volunteer time off.

• Incentive Plan.

• Tuition Reimbursement.

• Flexible work environment.

• Opportunities for training and continuing education.

• Community volunteering opportunities.