Responsible for auditing client and benefit setup.
Validates Client Specific Benefits testing.
Performs comprehensive group setup audits to identify processor accuracy and/or compliance issues to ensure quality setup for clients.
Responsible for quality review of medical product/benefit accuracy, pharmacy, and other ancillary products.
Analyzes error trend data and shares trends and opportunities with leadership.
Supports testing and validation activities for all annual portfolio builds. Responsibilities
Conducts audits of client setup documents, including benefit templates. Responsible for client specific benefit template audits.
Document audit findings, draft audit summaries and comprehensive audit reports and present to Sales
Audits Account Installation new business groups for in accordance to the established Underwriting guidelines.
Audits client benefit changes, administration changes and cancelations in accordance to the established Client Set Up and Underwriting Guidelines.
Must ensure necessary documentation is received, product information is accurate, and rates are confirmed before the group is approved or benefits changes are processed.
Meet departmental production standards and quality requirements.
Properly document and track assigned inventory.
Handle errors and internal/external issues in a timely and effective manner to maintain turnaround times for completion of customer/group set-up.
Develop and maintain positive client relationships with internal and external customers and Account Executives.
Participate in special projects regarding customer implementation and changes.
Recommend process changes to increase departmental efficiency.
Perform additional duties as assigned.

Education Bachelor's Degree preferred. In lieu of degree, must have 1-2 years relevant experience. Experience Minimum 1-year relevant experience required; Audit experience preferred. Auditing, quality review or transaction processing experience required. Knowledge, Skills, Abilities Considerable knowledge of audit processes and requirements, including organization and storage of documentation. Well versed in best practice process and procedures. In-depth knowledge of healthcare products, benefits, and systems. Proven effectiveness in managing to project targets and deadlines. Demonstrated effective project management skills necessary. Must be able to work independently. Ability to audit client documents to ensure benefits and products are set up correctly. Flexibility and adaptability are a must. Willingness to be cross trained is required to assist other team members. Strong communications skills required - position interacts with all levels of management and may communicate with external clients as well. Excellent time management and organizational skills required. Ability to prioritize workload and meet deadlines in a fast-paced environment without supervision. Knowledge of systems, process flows, regulatory impacts, and timelines to ensure requirements and implementation comply across operational disciplines. Skilled in trend analysis and highly effective in communicating as the liaison with business partners on findings and recommendations focused on minimizing impacts to other areas and the customer. Ability to review and analyze data to identify patterns of incorrect benefit setup and benefit application of the setup in accordance with sound audit methods and practices. Must be strong problem-solver and be able to follow-up and take an issue to resolution. Strong understanding of benefits and underwriting rating methodology. Capability to understand Underwriting guidelines and apply them. Strong critical thinking skills. High level technical aptitude required - ability to use Microsoft Office and to learn proprietary and vendor systems. Demonstrated experience with Microsoft products (Word, Excel and Power Point.) Independence has implemented a \"Hybrid\" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the \"Hybrid\" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania. IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app. Inclusion and Belonging At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. About Our Company Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day. At Independence, we see each of our members as an individual, with unique needs and concerns. We're dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com . We're revolutionizing health care, and our focus is on you! Equal Employment Opportunity IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. Agency Disclaimer All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process. Current Associates Applying for a position? Click here to return to the internal career site. Current Associates My Profile Create and manage profiles for future opportunities, and review prior submissions. 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