Audit & Compliance Specialist

Delta Dental of Minnesota•Minneapolis, MN

5d•$26 - $32•Onsite

About The Position

The Audit & Compliance Specialist is responsible for monitoring and successfully managing regulatory inquiries, coordinating audit schedules, and ensuring the implementation of corrective action plans. This role acts as a key liaison and subject matter expert, collaborating with internal functional leaders, external service administrators and vendor partners to monitor delegated tasks, maintain functional process documentation, and ensure alignment with contractual and statutory requirements. Additionally, the role drives accountability by participating in regulatory workgroups, managing targeted action items, and maintaining up-to-date knowledge of evolving policies and programs to support the Government Programs and regulated lines of business. This position will be with Stratacor, an affiliate of Delta Dental of Minnesota.

Requirements

Strong verbal, written, and presentation skills.
Excellent interpersonal skills with the ability to build relationships with internal and external stakeholders.
Ability to multi-task, self-motivate, and successfully operate in a fast-paced, team environment.
Ability to manage time effectively and meet established deadlines.
Must adapt well to change and successfully set and adjust priorities as needed with an appropriate sense of urgency.
Capable of researching an issue, issue spotting, and following through to its conclusion/resolution.
Ability to demonstrate considerable tact, diplomacy, discretion, and judgement when interacting with others, while also having the ability to build and maintain effective interpersonal relationships.
Ability to collaborate and partner with internal and external stakeholders at all levels.
Must have a high level of organizational skills, self-discipline, and motivation.
Ability to follow policies and procedures and help develop process improvement opportunities to improve efficiencies while using good judgement.
Solution driven problem-solving skills and proven analytical skills.
Ability to work independently and/or with little oversight, applying education and professional experience to achieve outstanding results.
Strong proficiency in MS Office (e.g., Outlook, Word, Excel, and PowerPoint).
Bachelor's degree in business or related degree; and/or equivalent work experience.
2+ years of experience working in healthcare insurance.
Experience researching and resolving customer and/or vendor inquiries.

Nice To Haves

Auditing or compliance related work experience.
Dental insurance industry experience.

Responsibilities

Investigate, resolve, and maintain documentation for auditing, monitoring, and regulatory inquiries received from regulators, health plan partners, and enterprise clients.
Administer and coordinate audit schedule with applicable stakeholders, ensure corrective action plans are documented and implemented.
Collaborate with external service administrator to ensure delivery of tasks in a timely manner.
Maintain up to date knowledge of policies, processes, and programs.
Perform special projects and assignments within established timeframes.
Provide audit subject matter expertise and support with stakeholders throughout Company.
Facilitate and verify processes with vendor partner on ongoing basis to ensure standards are being met.
Review and monitor delegated tasks to ensure compliance of contract and statutory requirements.
Responsible for drafting functional process documentation, obtaining approvals as necessary, and maintaining documentation.
Partner with internal functional leaders and teams to ensure regulatory requirements have been implemented as needed throughout Company.
Attend regulatory and internal workgroups; capture notes, decisions, and action items and ensure follow-through with accountable owners including fulfillment, updates to third party administrator (TPA) processes, benefits, and documentation.