[Remote] Business Process Auditor Associate

Note: The job is a remote job and is open to candidates in USA. Blue Cross NC is seeking a Business Process Auditor Associate to provide independent and objective assurance and advisory services within a health plan environment. The role involves planning and executing risk-based audits, evaluating governance, risks, and controls, and ensuring compliance with regulatory requirements.

Responsibilities

• Assist in planning and executing risk‑based audit and advisory engagements in accordance with IIA standards, the internal audit charter, and departmental methodology
• Develop an understanding of payer‑specific risks, including regulatory compliance, delegation oversight, operational accuracy, timeliness requirements, and data reliability
• Perform assigned audit procedures including walkthroughs, risk identification and assessment, and control identification and testing
• Support audits covering areas such as claims processing, utilization management, quality programs, enrollment, appeals and grievances, delegated arrangements, and third‑party oversight
• Prepare complete, accurate, and well‑organized audit workpapers that support conclusions and are suitable for management, regulatory, and external review
• Apply professional skepticism and due professional care when evaluating evidence and compliance with requirements
• Communicate professionally with business partners operating in a highly regulated environment
• Assist in drafting clear, factual, and risk‑focused audit observations that align with audit standards and departmental expectations
• Support tracking and validation of management action plans and corrective actions
• Adhere to the IIA Code of Ethics, maintaining integrity, objectivity, confidentiality, and competency
• Handle sensitive member, provider, and operational information in accordance with confidentiality and privacy requirements
• Maintain independence and objectivity and appropriately escalate potential conflicts of interest or impairments
• Build foundational knowledge of health plan operations, regulatory requirements, and internal control frameworks
• Participate in training, coaching, and feedback to develop audit skills and payer‑specific business acumen
• Demonstrate commitment to continuous learning and progress toward professional certifications (e.g., CIA, CPA, CISA)

Skills

• Bachelor's degree or advanced degree (where required)
• 0-2 years of experience in related field
• In lieu of degree, 3+ years of experience in related field
• Assist in planning and executing risk‑based audit and advisory engagements in accordance with IIA standards, the internal audit charter, and departmental methodology
• Develop an understanding of payer‑specific risks, including regulatory compliance, delegation oversight, operational accuracy, timeliness requirements, and data reliability
• Perform assigned audit procedures including walkthroughs, risk identification and assessment, and control identification and testing
• Support audits covering areas such as claims processing, utilization management, quality programs, enrollment, appeals and grievances, delegated arrangements, and third‑party oversight
• Prepare complete, accurate, and well‑organized audit workpapers that support conclusions and are suitable for management, regulatory, and external review
• Apply professional skepticism and due professional care when evaluating evidence and compliance with requirements
• Communicate professionally with business partners operating in a highly regulated environment
• Assist in drafting clear, factual, and risk‑focused audit observations that align with audit standards and departmental expectations
• Support tracking and validation of management action plans and corrective actions
• Adhere to the IIA Code of Ethics, maintaining integrity, objectivity, confidentiality, and competency
• Handle sensitive member, provider, and operational information in accordance with confidentiality and privacy requirements
• Maintain independence and objectivity and appropriately escalate potential conflicts of interest or impairments
• Build foundational knowledge of health plan operations, regulatory requirements, and internal control frameworks
• Participate in training, coaching, and feedback to develop audit skills and payer‑specific business acumen
• Demonstrate commitment to continuous learning and progress toward professional certifications (e.g., CIA, CPA, CISA)
• Exposure to analytics and data visualization tools such as Power BI or Tableau
• Demonstrated critical thinking and analytical skills, with the ability to evaluate information and apply sound judgment in a collaborative environment
• Interest in developing a career within Internal Audit, including learning the health insurance business and internal control environment
• Motivation to pursue professional certifications such as CIA, CPA, or CISA as part of long‑term career progression
• Willingness to work in a hybrid environment, with the ability to be onsite at the Durham campus as needed to support training, collaboration, and development

Benefits

• Medical, dental, and vision coverage along with numerous health and wellness programs.
• Parental leave and support plus adoption and surrogacy assistance.
• Career development programs and tuition reimbursement for continued education.
• 401k match including an annual company contribution

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