Blue Cross and Blue Shield of Louisiana Jobs

Job Information

Blue Cross and Blue Shield of Louisiana Auditor in Baton Rouge, Louisiana

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Please note that effective Jan. 4, 2022, Blue Cross and Blue Shield of Louisiana will require any employee who enters any of our offices or who interacts in person with anyone for company business purposes to be fully vaccinated for COVID‑19, unless legally entitled to a reasonable accommodation related to religious or medical exemptions. Please note this is subject to change at any point in time to ensure compliance with company policy or government mandates.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

Responsible for conducting and in some instances leading audits, investigations, and consulting engagements to provide management with the necessary information to improve and maximize the value of the organization. Provides management with insights and recommendations better to manage risks, strengthen internal controls and deter or recover losses due to fraud and abuse. Accountable for complying with all laws and regulations that are associated with duties and responsibilities.

NATURE AND SCOPE

  • This role does not manage people

  • This job reports to: Departmental Leadership

Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with:

Employees at all levels

External contacts include:

Providers, subscribers, group leaders, external consultants, attorneys, external auditors, governmental agencies, all levels of prosecutorial agencies other Blue Cross plans, and agencies/businesses as needed.

QUALIFICATIONS

Education

  • Bachelor's Degree in Audit, Accounting, Criminal Justice or a related field as deemed necessary by department management required

  • Four years of related experience can be used in lieu of a Bachelor’s degree.

Work Experience

  • 2 years of experience in a predominantly analytical position related to audit, fraud investigations, medical procedures or information technology required

  • Internal audit experience preferred

Skills and Abilities

  • Position requires strong human relations skills in addition to analytical ability. Also, strong communication skills both written and oral.

  • Ability to manage time and personnel on a project basis (1-3 personnel at a time).

  • Working knowledge of relevant software is required.

  • Incumbent must maintain complete confidentiality of information encountered.

Licenses and Certifications

  • An approved certification such as CIA, CPA, CFE, CISA, or other business or clinical licensures (e.g. RN) as approved by department management preferred

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

  • Defines, executes and administers assigned audits/fraud cases and special projects to ensure established objectives are met, facts are properly presented and adequate conclusions are reached while demonstrating sound judgment/decision making and commitment to tasks.

  • Participates in developing and analyzing corporate enterprise actual and perceived fraud risks and changes in business operations to ensure that the Company’s exposure is minimized or mitigated.

  • Develops and applies an understanding of unit’s risk methodology as well as current business operations to ensure that BCBSLA exposures are minimized or mitigated.

Additional Accountabilities and Essential Functions

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

  • Perform other job-related duties as assigned, within your scope of responsibilities.

  • Job duties are performed in a normal and clean office environment with normal noise levels.

  • Work is predominately done while standing or sitting.

  • The ability to comprehend, document, calculate, visualize, and analyze are required.

#LI_RF1

An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.

In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

JOB CATEGORY: Legal, Compliance & Audit

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