Senior Compliance Auditor

Posted yesterday

virtual vocationsDenver (CO)

Accountants and AuditorsOther Management Consulting Services

SENIORITY

Senior

About the role

To support comprehensive Medical Loss Ratio (MLR) examinations remotely, the full-time Senior Compliance Auditor will analyze documentation, perform attribute testing, and review compliance with state and federal regulations in the healthcare and insurance sectors. Key responsibilities Conduct analytical reviews of documentation to ensure compliance with MLR calculations and rebate distributions Perform testing of premium and claims transactions for accuracy and completeness related to MLR calculations Review Quality Improvement Activity expenses and Pharmacy Benefit Manager contracts for regulatory compliance Required qualifications Minimum 2+ years of experience in auditing or accounting within healthcare, insurance, or related fields Experience with MLR and related rebate requirements is required Bachelor's Degree in Accounting or Finance preferred CPA, CIA, CFE, or AFE certifications preferred but not required Proficiency in software tools such as TeamMate, ACL/Access/Tableau, and MS Excel

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