Junior Auditor

This is an entry level position for individuals who are looking for an opportunity to get their foot in the door with a reputable company and grow their career. In this role you will be trained to audit healthcare information and provides a great opportunity to begin your career path in the Accounting & Finance industry. Start Date: 7/6/2026 Starting Pay: $45,500/year MUST HAVE Bachelor's Degree in Accounting OR Finance, BBA is not accepted by this employer. Responsibilities:

• Understand the Regulatory Framework: Familiarize yourself with the relevant regulations governing health insurance rates in your jurisdiction. This could include state or federal laws, guidelines from regulatory bodies, and any recent updates or changes that impact rate setting.
• Define the Audit Scope: Determine the scope and objectives of the audit. Identify the health insurance plans or policies to be audited, such as individual plans, group plans, or specific product lines. Clarify whether the focus is on premium rates, cost-sharing arrangements, or both.
• Gather Rate Data: Obtain the necessary data from the insurance company or plan administrator. This typically includes rate schedules, rate filings, policy documents, benefit summaries, and any other relevant information. Ensure the data is comprehensive and covers the relevant time period.
• Review Rate Calculation Methodology: Examine the methodology used by the insurance company to calculate rates. Understand the key factors considered in rate determination, such as age, gender, location, risk factors, and medical underwriting. Assess if the methodology aligns with regulatory requirements and industry best practices.
• Evaluate Actuarial Assumptions: Analyze the actuarial assumptions used in rate setting. These may include projected claims costs, administrative expenses, profit margins, and anticipated utilization patterns. Verify that the assumptions are reasonable, supported by appropriate data, and consistent with historical trends.
• Assess Pricing Accuracy: Compare the calculated rates with the actual premiums charged to policyholders. Verify that the rates are accurately applied and comply with contractual obligations. Investigate any discrepancies or potential instances of rate overcharging or undercharging.
• Analyze Cost Components: Break down the rate structure into its various cost components, such as medical costs, overhead expenses, commissions, and risk margins. Assess the reasonableness of each component and compare them against industry benchmarks or historical data to identify any outliers.
• Validate Compliance: Ensure that the rates adhere to regulatory requirements, such as rate bands, community rating rules, or any specific state-mandated provisions. Verify that the rate filings are complete, timely, and comply with disclosure requirements.
• Identify Rate Adequacy: Evaluate the adequacy of rates by assessing the financial sustainability of the insurance plans. Analyze historical loss ratios, claims experience, and other relevant financial indicators to determine if the rates are sufficient to cover projected costs and maintain a reasonable profit margin.
• Document Findings and Recommendations: Prepare a comprehensive audit report documenting your findings, including any identified deficiencies, compliance issues, or recommendations for improvements. Communicate the results to the appropriate stakeholders, such as management, regulatory bodies, or auditors.

Qualifications:

• Bachelor's Degree in Accounting OR Finance. BBA is not accepted by this employer, unfortunately.
• Proficient with Microsoft Office Suite
• Excellent communication skills
• Strong attention to detail

"Ascendo is a certified minority owned staffing firm, and we welcome and celebrate diversity. Ascendo is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, parental status, military service or any other characteristic protected by federal, state or local law. " Apply To This Job