Top 207 blue cross blue shield Jobs

Auditor (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $50,904 - $101,101 a year
- Online Application
- Remote
- CPA
- Mid-level
- Finance
Quick Apply
Enrollment Technician I (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $31,824 - $58,344 a year
- Online Application
- Remote
- High school diploma or GED
- US work authorization
- 1 year
- 401(k)
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Business Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $60,840 - $120,835 a year
- Online Application
- Remote
- Computer Science
- Mid-level
- 3 years
- 401(k)
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Lead Auditor, Medicare
BlueCross BlueShield of South Carolina —Alabama
- $30,227.50 - $60,588.00 a year
- Part-time
- Remote
- 7 years
- CPA
- Bachelor's degree
- Health insurance
- Dental insurance
Claims Adjuster III (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $44,136 - $80,916 a year
- Full-time
- Remote
- 7 years
- High school diploma or GED
- Mentoring
- 401(k)
Quick Apply
8d
Business Consultant (Remote)
CareFirst BlueCross BlueShield —Reston, VA
- $88,848 - $176,462 a year
- Online Application
- Remote
- Mid-level
- Bachelor's degree
- Continuous improvement
- 401(k)
Quick Apply
Claims Processor I (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $33,408 - $61,248 a year
- Full-time
- Remote
- Computer literacy
- Research
- High school diploma or GED
- 401(k)
Quick Apply
1d
Regulatory Compliance Analyst (Remote) - Privacy
CareFirst BlueCross BlueShield —Baltimore, MD
- $54,864 - $108,966 a year
- Online Application
- Remote
- Research
- Mid-level
- Bachelor's degree
- 401(k)
Quick Apply
Auditor III
BlueCross BlueShield of South Carolina —Columbia, SC
- Full-time
- Remote
- CPA
- 5 years
- Office
10d
Program Manager (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $106,632 - $211,783 a year
- Full-time
- Remote
- Master's degree
- Analysis skills
- Bachelor's degree
- 401(k)
Quick Apply
Senior Business Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $71,280 - $141,570 a year
- Online Application
- Remote
- Computer Science
- Research
- Analysis skills
- 401(k)
Quick Apply
Medical Management Coordinator I (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $39,024 - $71,544 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- 401(k)
Quick Apply
2d
General Clerk II (Hybrid)
CareFirst BlueCross BlueShield —Baltimore, MD
- $33,480 - $61,380 a year
- Online Application
- Mid-level
- Administrative experience
- High school diploma or GED
Quick Apply
Clinical Navigator (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $72,360 - $143,715 a year
- Online Application
- Remote
- Spanish
- Nursing
- Microsoft Excel
Quick Apply
Actuarial Associate (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $102,384 - $211,167 a year
- Online Application
- Remote
- Mid-level
- Finance
- Analysis skills
Quick Apply
Senior Business Analyst (Remote) - Pharmacy
CareFirst BlueCross BlueShield —Baltimore, MD
- $73,728 - $146,432 a year
- Online Application
- Remote
- Computer Science
- Analysis skills
- Bachelor's degree
Quick Apply
Regulatory Operations Manager (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $112,960 - $209,682 a year
- Online Application
- Remote
- Analysis skills
- Bachelor's degree
- Mentoring
- 401(k)
Quick Apply
Lead Data Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $102,456 - $203,489 a year
- Online Application
- Remote
- Azure
- Computer Science
- SQL
- 401(k)
Quick Apply
Claims Processor I
BlueCross BlueShield of South Carolina —Columbia, SC
- Full-time
- Customer service
- Word processing
- Basic math
- Health insurance
- Dental insurance
Regulatory Policy Consultant (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $124,880 - $223,223 a year
- Online Application
- Remote
- Finance
- Analysis skills
- Bachelor's degree
- Health insurance
Quick Apply

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Auditor (Remote)

CareFirst BlueCross BlueShield -
Baltimore, MD

Quick Apply

Job Details

Full-time
$50,904 - $101,101 a year

Qualifications

Computer skills

Full Job Description

Resp & Qualifications

PURPOSE:
Assess the organization's operational, financial, regulatory and compliance controls to ensure processes function efficiently and remain in compliance with CareFirst policies, procedures and regulations. Evaluates internal control processes to identify potential control deficiencies. Report audit findings to the supervisor or manager and recommend solutions to improve overall processes and control governance.

ESSENTIAL FUNCTIONS:

Perform a variety of internal audit projects including operational, financial, regulatory and compliance, consulting projects, special reviews and management requests. Analyze and evaluate operations and strategies to identify opportunities for improvement in processes. Participate in the development of the risk assessment for the business process or project under review. Perform process walkthroughs and participate in the Entrance and Exit meetings. Assist in drafting audit findings, management action plans and draft report for management review. Maintain audit documentation in automated workpaper repository of business processes and related risks. Support with follow-up activities to validate completion of action plans.
Support project monitoring initiatives by tracking audit and project milestones, identifying emerging risks, and coordinating with stakeholders to ensure timely completion of audit activities and related deliverables.
Perform Model Audit Rule (MAR) activities, including testing and evaluating internal controls in accordance with regulatory requirements, documenting results, supporting issue identification and remediation tracking, and reporting MAR-related results and trends to audit leadership.
Assist in monitoring the progress of operational, financial, regulatory and compliance audits as assigned, including participation in project monitoring activities to track project timelines, dependencies, risks and issue resolution. Contribute to the development of efficient and effective audit objectives, programs and testing procedures. Document walk-throughs of business processes utilizing flowcharting application (e.g., VISIO). Advise and consult on risk management and controls for new processes associated with the assigned projects, as appropriate, and demonstrate willingness to learn and apply IT General Controls (ITGCs) in support of technology-enabled processes. Follow-up with business owner/management to resolve identified issues, including internal control testing.
Maintain a repository of operational, financial, regulatory and compliance audit issues and related corrective action plans. Monitor and provide periodic updates to the Senior and Lead auditors on the status of outstanding management action plans. May assist with monitoring remediation efforts related to technology and IT-enabled controls as experience and training are obtained.
Assist in the coordination of external vendor audit, as well as operational, financial, regulatory and compliances audits as assigned.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Business Administration, Management Sciences, Finance, Accounting or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Licenses/Certifications Preferred:

Certified Internal Auditor (CIA)
Certified Public Accountant (CPA)
Certified Fraud Examiner (CFE)

Experience: 1 year Experience in accounting, finance, auditing, insurance or relevant work experience in an operational capacity in the health care industry.

Preferred Qualifications:

Preferred that individual possess or is in the process of obtaining a professional certification in one of the following CPA, CIA, CFE, or other relevant professional certifications.

Knowledge, Skills and Abilities (KSAs)

Some knowledge of operational processes, state and federal regulatory and compliance guidelines, accounting principles and practices, with data analytic tools (e.g., Excel).
Knowledge of various auditing methods, practices, standards (e.g., IIA).
Recognize, analyze, and provide possible solutions for a variety of problems.
The ability to communicate effectively both oral and written.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $50,904 - $101,101

Travel Requirements
Estimate Amount: 5% Travel to various CareFirst offices, vendor locations, and training facilities.

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Audit and Advisory Services

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

#LI-LJ1

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Refine Your Search

blue cross blue shield jobs

Auditor (Remote)

Enrollment Technician I (Remote)

Business Analyst (Remote)

Lead Auditor, Medicare

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Claims Processor I (Remote)

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Auditor III

Program Manager (Remote)

Senior Business Analyst (Remote)

Medical Management Coordinator I (Remote)

General Clerk II (Hybrid)

Clinical Navigator (Remote)

Actuarial Associate (Remote)

Senior Business Analyst (Remote) - Pharmacy

Regulatory Operations Manager (Remote)

Lead Data Analyst (Remote)

Claims Processor I

Regulatory Policy Consultant (Remote)

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