Senior Audit Lead

BASIC FUNCTION

The Senior Audit Lead will assist the Internal Audit Manager and will lead a team of auditors in performing in-depth audits of Farm Bureau Health Plans’ operations functions, as well as the functions delegated to third-party entities, to ensure compliance with state and federal regulatory requirements and FBHP policies and procedures.

REPORTS TO

Internal Audit Manager

GENERAL RESPONSIBILITIES

The Senior Audit Lead will provide oversight of audit functions for internal audits, audits of third-party entities, and external audits. The Senior Audit Lead will work closely with the Internal Audit Manager to review departmental risk assessments and the development of annual audit plans. The Senior Audit Lead provides effective leadership and management of FBHP’s Audit Analysts. General responsibilities include:

- Audit Planning and Execution:

• Conduct comprehensive audits of operational functions to ensure adherence to company policies and regulatory requirements.
• Develop and implement audit programs and methodologies based on company-specific and industry standards.
• Prepare detailed audit plans, outlining scope, objectives, and procedures for each audit project.
• Identify areas of risk and provide recommendations for improvements to mitigate potential issues.

- Risk Assessment and Internal Control Evaluation:

• Assess the adequacy and effectiveness of internal controls in various departments (e.g., underwriting, claims processing, customer service).
• Review internal processes and recommend improvements to enhance risk management practices and operational efficiency.
• Identify potential risks within health insurance operations such as claims fraud, billing errors, or compliance violations.

- Compliance Monitoring:

• Monitor compliance with relevant health insurance regulations (e.g., HIPAA, state insurance laws) and company policies.
• Stay updated on changes in regulatory requirements, ensuring the company’s policies and procedures remain compliant.
• Support the company in audits by regulatory agencies and external auditors.

- Reporting and Communication:

• Prepare clear, concise, and comprehensive audit reports, documenting findings, recommendations, and management responses.
• Present audit results to senior management and the Enterprise Risk and Compliance Committee, explaining complex issues in a digestible format.
• Provide ongoing support and guidance to departments to help them resolve issues identified during audits.

- Continuous Improvement:

• Suggest improvements to audit processes and tools to increase efficiency and effectiveness.
• Maintain working knowledge of emerging trends and best practices in internal auditing within the health insurance industry.
• Support internal training and development initiatives to improve the company’s overall internal controls and audit awareness.

- Collaboration:

• Work closely with department heads and cross-functional teams to gather relevant data for audits and assist in implementing corrective actions.

QUALIFICATIONS

Education: Bachelor’s Degree in Accounting, Finance, Business Administration, or a related field. Professional certifications such as Certified Internal Auditor (CIA) or Certified Public Accountant (CPA) preferred.

Work Experience:

• Must have 3 years of experience in internal auditing, preferably within the health insurance or financial services sector.
• Strong understanding of health insurance operations, regulatory frameworks (e.g., HIPAA), and risk management practices.

Skills/Competencies: A successful candidate for the Senior Audit Lead will possess the following skills and/or competencies:

• Understanding of health plan benefits;
• Ability to research and interpret state and federal regulations, FBHP policies and procedures, and health plan benefit contracts;
• Intermediate to advanced skills in Excel, MS Word, Outlook, and Power Point;
• Project management;
• Willingness to learn and take initiative;
• Strong attention to detail;
• Analytical and problem-solving skills;
• Understands privacy and confidentiality;
• Strong organizational and time management skills;
• Ability to work independently;
• Excellent interpersonal skills;
• Excellent verbal and written communication skills.