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Blue Cross and Blue Shield of Kansas एक पॉलिसीधारक-स्वामित्व वाली पारस्परिक स्वास्थ्य बीमा कंपनी है, जो पूरे कंसास में समुदायों की सेवा करती है। राज्य की सबसे बड़ी स्वास्थ्य बीमा कंपनी के रूप में, यह कंपनी देशभर में स्वतंत्र रूप से संचालित 36 योजनाओं के साथ Blue Cross Blue Shield Association के अंतर्गत काम करती है। टोपीका में स्थित BCBSKS पूरे कंसास में लगभग 1,400 लोगों को रोजगार देता है और 16 कंसास निवासियों वाले निदेशक मंडल द्वारा संचालित है, जिसमें ग्राहक और स्वास्थ्य सेवा संबंधी दृष्टिकोणों सहित विभिन्न विशेषज्ञताओं का प्रतिनिधित्व है। इसके संचालन में स्वास्थ्य सेवा प्रदाताओं को हर वर्ष 1 अरब डॉलर से अधिक के दावों का भुगतान करना और वेतन तथा करों के माध्यम से कंसास की अर्थव्यवस्था में 140 मिलियन डॉलर से अधिक का योगदान देना शामिल है।
Benefit and Performance Auditor
Conduct audits of insurance benefits, contract compliance, and performance. Identify control gaps, report findings, and help strengthen accountability at Blue Cross and Blue Shield of Kansas.
विवरण
- Evaluate contracts, policies, and regulatory compliance through benefit and performance audits.
- Review operational processes for control weaknesses and recommend corrective steps.
- Document audit procedures, findings, and reports with accuracy and detail.
- Share audit results and recommendations with department leaders and internal partners.
- Provide documentation and context for external audits and regulatory reviews.
- Keep current on benefit programs, auditing practices, and system capabilities.
- Train and guide auditors with less experience.
- Protect confidential information and handle sensitive data securely.
- Work with internal teams and external partners to address audit findings.
- Help refine audit methods and procedures.
आवश्यकताएँ
- Apply strong analytical and critical thinking skills, with careful attention to detail.
- Understand benefit administration and contract performance standards.
- Manage several audits independently while adapting to shifting priorities.
- Use audit software and Microsoft Office applications effectively.
- Communicate clearly in writing and conversation and work well with others.
- Interpret and apply company policies, procedures, and regulatory guidance.
- Investigate problems and identify their underlying causes.
- Keep audit records and supporting documentation well organized.
- High school diploma or equivalent.
- At least five years of experience in insurance customer service, claims, membership, or a related audit role.
- Experience in benefit performance auditing or related health insurance work is preferred.
- Work at a computer for extended periods.
- Meet tight deadlines and adapt to changing audit schedules.
- Minimal travel may be needed for audit work.
- As a condition of an offer, candidates must complete pre-employment drug screening, criminal conviction and employment checks, and education verification.
लाभ
- Paid vacation and sick leave.
- Paid maternity and paternity leave available from the start of employment.
- Incentive pay through the EPIP program.
- Health, vision, and dental insurance.
- Six weeks of paid parental leave for new mothers and fathers.
- Fertility and adoption assistance.
- Two weeks of paid caregiver leave.
- 401(k) matching of up to 5%.
- Tuition reimbursement.
- Health and fitness benefits, discounts, and resources.
- Ongoing training and development.
- Flexible work environment.
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