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Infojini Inc · 6 hours ago

Auditor

Albany, NY

Contract

Onsite

Entry, Mid Level

2+ years exp

Infojini Inc is seeking a Financial Examiner to perform comprehensive reviews of pharmacy benefit managers in New York, ensuring compliance with insurance rules and regulations. The role involves conducting audits and examinations, focusing on regulatory compliance, financial integrity, and operational control related to pharmacy and medical benefits.

Information Technology

Responsibilities

Have knowledge of Generally Accepted Accounting Principles (GAAP) and Statements of Statutory Accounting principles (SSAP)

Research and consistently apply state laws, department regulations, National Association of Insurance Commissioners (NAIC) statutory accounting practices, and Federal Deposit Insurance Corporation (FDIC) regulations and practices

Knowledge of exam planning procedures, internal controls, sampling techniques, testing procedures, work paper preparation/documentation

Review procedures and report writing

Knowledge of financial analysis techniques and ratios

Understand and evaluate enterprise risk management, functions of insurers and pharmacy benefit managers

Think critically and make decisions based on reasonable and timely analysis

Understand and evaluate risks as well as risk mitigation strategies and controls

Multi-task and manage time effectively

Work and contribute to a team environment

Strong communication skills (both written and verbal)

Participate in presentations, discussions of examination findings

Adapt to complex and rapidly changing expectations and environments

Proficiency in MS Excel, Word and Outlook and MS Teams

Have familiarity with pharmacy benefit managers and/or health plans

Ability to review and test contracts between pharmacy benefit managers, insurers, health plans, pharmacies and manufacturers

Ability to analyze pharmacy and medical claims to identify discrepancies, risk and non-compliance

Stay current on regulatory developments affecting pharmacy benefits, health insurance, and managed care

Qualification

GAAPSSAPFinancial analysisRegulatory complianceMS ExcelMS WordMS OutlookMS TeamsContract reviewRisk evaluationCritical thinkingTime managementTeam collaborationCommunication skills

Required

Have knowledge of Generally Accepted Accounting Principles (GAAP) and Statements of Statutory Accounting principles (SSAP)

Knowledge of exam planning procedures, internal controls, sampling techniques, testing procedures, work paper preparation/documentation

Review procedures and report writing

Knowledge of financial analysis techniques and ratios

Understand and evaluate enterprise risk management, functions of insurers and pharmacy benefit managers

Think critically and make decisions based on reasonable and timely analysis

Understand and evaluate risks as well as risk mitigation strategies and controls

Multi-task and manage time effectively

Work and contribute to a team environment

Strong communication skills (both written and verbal)

Participate in presentations, discussions of examination findings

Adapt to complex and rapidly changing expectations and environments

Proficiency in MS Excel, Word and Outlook and MS Teams

Have familiarity with pharmacy benefit managers and/or health plans

Ability to review and test contracts between pharmacy benefit managers, insurers, health plans, pharmacies and manufacturers

Ability to analyze pharmacy and medical claims to identify discrepancies, risk and non-compliance

Stay current on regulatory developments affecting pharmacy benefits, health insurance, and managed care

A Bachelor's Degree or higher in accounting, auditing, economics, econometrics, business economics, finance, financial administration, mathematics, applied mathematics, mathematical sciences, statistics, actuarial science, or taxation

A Bachelor's Degree or higher, including or supplemented by 24 semester credit hours in accounting, auditing, economics, econometrics, business economics, finance, financial administration, mathematics, applied mathematics, mathematical sciences, statistics, actuarial science or taxation

Two years of experience in regulatory compliance related to pharmacy and/or medical benefits