External Audit Coord. Manager

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Job Description: Your future is bright at CareFirst. CareFirst BlueCross BlueShield is the largest health care insurer in the Mid-Atlantic region.  Every day, we help people make decisions that will positively impact their lives today and into the future. You can take your experience to the next level in a company that is financially strong and nationally respected.  We invite you to join us as a Senior External Audit Manager. Directly managing three auditors, the Senior External Audit Manager will supervise the coordination and scheduling of all external audits conducted by customers and regulators, including MIA, VBOI, DISR, HCFA and BCBSA. Responsibilities: Notify appropriate parties of the audit and schedule entrance and exit conferences Develop tools to assist staff in effectively coordinating audits (such as protocol sheet, exception logs, par plan status logs, etc) and hold staff meetings and one-on-ones Review customer contracts for audit rights and prepare necessary audit Confidentiality agreements and Par Plan addendum agreements.  Ensure Business Associate agreements are in place prior to releasing PHI.  Supervise the obtaining and reviewing of claim samples and documentation.  Ensure all HIPAA requirements applicable to the job are met Direct and oversee analysis of requested data in order to minimize Company risks.  Review findings and responses for adequacy and appropriateness.  Attend legislative committee meetings on regulation changes affecting CareFirst operations. Review draft/final audit reports from auditors.  Prepare responses to report findings.  Complete quarterly reports and follow-up for management’s response to action plan, Medicare Corrective Action Plan and High issues for CEO.  Qualifications: Bachelor’s degree in Business Administration, Management Science, Finance and/or Accounting and five years of progressively responsible financial auditing and management experience required Must have thorough understanding of financial and operational auditing theory and practices and MD, VA, and DC insurance regulations.  Certification such as CPA, CIA, or CISA is required.  Knowledge of claims benefits and processing is a plus. Incumbents must demonstrate analytical prowess, leadership qualities, functional expertise and business perspective; and possess excellent communication, interpersonal and PC skills.  We offer excellent benefits and a competitive salary. Our Baltimore campus is conveniently located in Owings Mills and offers free on-site parking and easy access to restaurants and shopping. For complete job description and/or to apply online, please visit us at www.carefirst.comand search for appropriate Req#001893. EOE, AA, M/F/D/V. CareFirst BlueCross BlueShield is an independent licensee of the Blue Cross and Blue Shield Association.® Registered trademark of the Blue Cross and Blue Shield Association.® Registered trademark of CareFirst of Maryland, Inc.  APPLY NOW Status: Full Time, Employee Job Location: Owings Mills, MD Job Ref Code: 001893About Carefirst BlueCross BlueShieldCareFirst BlueCross BlueShield, the largest health care insurer in the Mid-Atlantic region is a company that has mastered the art of making the complex simple. Every day, we help people make decisions that will positively impact their lives today and into the future. Serving Maryland, the District of Columbia and portions of Virginia. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®' Registered trademark of CareFirst of Maryland, Inc.