Executes a wide variety of audit tests/procedures and accurately interprets results against defined criteria. Understands the operational and compliance risks that affect HPP’s Operations; demonstrates the ability to identify and appropriately measure those risks; and formulates recommendations that are appropriate, practical, and cost-effective. Consistently documents relevant facts and information to support the work performed and conclusions drawn so operations representatives can follow the auditor's logic and methodology. Effectively evaluates audit results, weighing the relevancy, accuracy, and perspective of conclusions against the accumulated audit evidence. Effectively communicates audit results, both verbally and in writing, so they are clear and concise, placed in the appropriate context, and understood by the recipient. Conducts audits in accordance with professional and departmental standards. Knows when to seek guidance from supervising staff as circumstances warrant. Completes work assignments independently or as part of a team project. Interacts effectively with others in a professional manner. Demonstrates effective time management skills by completing assignments within assigned timeframes. Exhibits creativity and innovation in recommending improvements to departmental audit practices and processes. Education and Experience:Associate’s Degree from an accredited university / college in a relevant course of study or. High School Diploma/ GED in the absence of college coursework, at least two years in managed care or health insurance customer service, audit or quality assurance experience with a minimum of 4 years proficiency in a health insurance operational function will be considered. Working knowledge of current Applications and Core Systems that support the Enrollment business unit. Outstanding analytical, interpersonal, and written communication skills. Ability to communicate effectively. Medical Terminologyworking knowledge of HIPAA, and other related regulations. MS Office skills. Work Shift. Workday Day (United States of America)Worker Sub Type. Regular. Employee Entity. Health Partners Plans, Inc. Primary Location Address 1101 Market, Philadelphia, Pennsylvania, United States of America.