Insurance auditor vs audit specialist

Differences between insurance auditor and audit specialist duties and responsibilities

Insurance auditor example responsibilities.

• Manage the collection, analysis and verification of managerial payroll information to detect fraud and/or unethical practices.
• Prepare the audit report as prescribed by the insurance company within the time allow and within NCCI and ISO rules.
• Modify claim files upon customer request using proprietary software under strict HIPAA guidelines.
• Provide contract audit services to monitor the field sales force compliance with internal policies on promotional spending on healthcare providers.
• Audit paperwork to ensure products are produced within company and FDA specification.
• Develop and implement the recovery audit program for post-payment audit of dental Medicaid programs.
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Audit specialist example responsibilities.

• Manage vendor billing disputes for southwestern region from initiation to documentation of resolution while ensuring compliance with SOX guidelines.
• Work with department analyst to create measurement tools and methods for communicating results and managing QA analysis in compiling/reporting results.
• Review and verify the submitted documentation for completeness to verify the company is in compliance with Sarbanes-Oxley (SOX).
• Coordinate delivery of mortgage back securities with internal and external stakeholders.
• Monitor and maintain automated report generation and distribution via Cognos NoticeCast.
• Prepare monthly incentive payment and quarterly incentive bonus data for payroll department.
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