Compliance Audit Analyst Jobs

POSITION SUMMARY
Works with our clients (and/or their auditors) and Client Audit management as well as other internal subject matter experts as lead to manage audit tasks, timelines, create data universes, identify potential errors in processes and resolve audit issues noted during the Client Audit process. Serves as project lead and tracks status on deliverables within the audit and is responsible for ensuring the adherence to deadlines. Monitors contract terms and CMS guidelines to ensure documents and data meet CMS requirements. Point person in determining the appropriate documentation or data that is required to meet Client Audit requests. Meets regularly with Clients to provide updates on audit status. Will be responsible for managing approximately 15 audit projects at a time. This role will work to analyze thousands of pharmacy claims a year utilizing Microsoft Excel. Assists with troubleshooting issues and questions arising from the claims analysis completed for client audits. Prepares formal written responses to audit reports. Requires a variety of duties with the ability to change from one task to another of a different subject multiple times a day. Ability to recognize urgent situations and take appropriate action. Works independently and identifies areas for process improvements/efficiencies. Will also be responsible for completing audits to help develop working knowledge of audit process and to assist with department workload needs. Assist other members of the team with performing their job duties as needed.
ESSENTIAL FUNCTIONS:
Manages multiple audits with completing deadlines.
Discusses the audit with the client (and/or their auditor), government agencies (and/or their subcontractor), understanding and managing their expectations and working through any limitations that may be experienced due to confidentiality of information, etc.
This position requires the analyst to be able to anticipate the auditor’s and client’s needs. It also requires the ability to deal with sensitive situations.
Tracks status and serves as technical lead for client audit during routine audits and monitors contracts and CMS guidelines to ensure clients are requesting appropriate data.
Fields various requests for information and provides ongoing support for Client Audit as well as other subject matter experts as needed.
Completing audits to help develop working knowledge of audit process as well as assist with department workload needs.
Pharmacy claims analysis in Microsoft Excel.
QUALIFICATIONS
Bachelor’s degree preferably with focus in Finance, Accounting or other business related field.
1+ years of relevant work experience preferably with 1+ years of experience in financial analysis or auditing.
Microsoft Office including Excel, Access, Word, and Outlook.
Previous experience working with cross functional departments to research and resolve issues using innovative solutions.
Demonstrated ability to meet multiple deadlines and manage a dynamic workload, well organized.
Demonstrated analytical and problem solving skills.
Detail oriented; Excellent verbal and written communication skills along with presentation skills.
Ability to handle sensitive or confidential information is critical.
Ability to work a flexible schedule to accommodate project deadlines.
ABOUT THE DEPARTMENT
If your niche is in financial reporting and analysis, underwriting, cash management, audit or investor relations, our Finance department may be a perfect fit for you. Our teams within Finance work together to ensure that spending stays on track and that we remain a profitable industry leader. We’re always on the lookout for innovative people who will bring outside-the-box thinking to our team.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.