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Blue Cross and Blue Shield of KansasCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting benefit and performance audits, ensuring compliance with contracts and regulatory requirements while providing training and support to less experienced auditors. Proficient in analyzing operational processes and presenting findings to leadership, with a strong focus on problem-solving and maintaining confidentiality.
Highest-signal resume keywords
Benefit Administration KnowledgeAudit Methodologies DevelopmentAnalytical SkillsRegulatory Compliance InterpretationAudit-Related Software Proficiency
About the role
Key responsibilities & impact- Conduct benefit and performance audits to evaluate compliance with contracts, policies, and regulatory requirements
- Analyze operational processes to identify internal control weaknesses and recommend corrective actions
- Prepare accurate and detailed audit work papers, findings, and reports
- Present audit findings and recommendations to department leadership and other internal stakeholders
- Support external audits and regulatory reviews by providing requested documentation and insight
- Maintain up-to-date knowledge of benefit programs, audit practices, and system functionality
- Provide training, direction, and support to less experienced auditors
- Ensure confidentiality and secure handling of sensitive data
- Collaborate with internal departments and external partners to resolve audit conditions
- Assist in developing and improving audit methodologies and procedures
Requirements
What you’ll need- Strong analytical and critical thinking skills with attention to detail
- Knowledge of benefit administration and contract performance standards
- Ability to independently manage multiple audits and changing priorities
- Proficient in using audit-related software and Microsoft Office applications
- Excellent verbal and written communication and interpersonal skills
- Ability to interpret and apply corporate policies, procedures, and regulatory guidelines
- Demonstrated problem-solving abilities with a focus on root cause analysis
- Strong organizational and documentation skills
- High school diploma or equivalent required
- Minimum of 5 years’ experience in insurance customer service, claims, membership or related audit experience required
- Experience with benefit performance auditing or related health insurance functions preferred
- Must be able to work at a computer for extended periods of time
- Ability to meet strict deadlines and adapt to changing audit schedules
- Minimal travel may be required for audit purposes
- Successful candidates are subject to pre-employment drug screening, criminal conviction check, employment verifications, and education verification as part of a conditional offer
Benefits
Comp & perks- Paid vacation and sick leave
- Paid maternity and paternity leave available immediately upon hire
- Incentive pay program (EPIP)
- Health/Vision/Dental insurance
- 6 weeks paid parental leave for new mothers and fathers
- Fertility/Adoption assistance
- 2 weeks paid caregiver leave
- 401(k) plan matching up to 5%
- Tuition reimbursement
- Health & fitness benefits, discounts and resources
- Ongoing training and development programs
- Flexible work environment
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Benefit Performance AuditingOperational Process AnalysisAudit Work Paper PreparationRoot Cause AnalysisDocumentation SkillsContract Performance Standards KnowledgeMicrosoft Office ProficiencyAudit Compliance EvaluationData Confidentiality ManagementTraining and Direction Provision
Soft Skills
Analytical ThinkingAttention to DetailVerbal CommunicationWritten CommunicationInterpersonal Skills
Tools & Technologies
Audit-Related SoftwareMicrosoft Office Applications
Industry Keywords
Insurance Customer ServiceClaims ManagementMembership AuditingHealth Insurance FunctionsRegulatory Guidelines