Audit & Compliance Specialist

Delta-Dental; Minneapolis (MN); On-site; USD 36,000 - 44,000; Full time

Job summary

Delta Dental of Minnesota affiliate Stratacor seeks an Audit & Compliance Specialist to monitor regulatory inquiries, coordinate audit schedules, and implement corrective actions. You will liaise with internal leaders, external administrators, and vendor partners to ensure contractual and statutory compliance.

This role is with Stratacor, an affiliate of Delta Dental of Minnesota, and requires authorization to work in the U.S. The starting hourly salary ranges from $26.00 to $32.00.

Qualifications

• Bachelor's degree in business or related field required.
• 2+ years of experience in healthcare insurance required.
• Experience researching and resolving customer or vendor inquiries required.

Responsibilities

• Investigate, resolve, and document auditing, monitoring, and regulatory inquiries from regulators, health plan partners, and enterprise clients.
• Coordinate audit schedules with stakeholders and ensure corrective actions are documented and implemented.
• Collaborate with external service administrators to ensure timely delivery of tasks.

Skills

Verbal communication

Interpersonal skills

Multi-tasking

Time management

Adaptability

Issue resolution

Diplomacy

Collaboration

Organizational skills

MS Office

Education

Bachelor's degree in business or related field

Tools

MS Office

Job description

Delta Dental of Minnesota is the largest regional provider of dental benefits, passionately serving over 7,000 Minnesota and North Dakota-based purchasing groups and 4.5 million members nationwide. We provide a work environment that engages each individual while encouraging growth and professional development. We are proud to be named a Top Workplace employer for several consecutive years and value our team members for building this reputation.

GENERAL SUMMARY

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.

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment authorization at this time.

ESSENTIAL FUNCTIONS

• 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.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the team member. Duties, responsibilities and activities may change or be assigned at any time with or without notice.

KNOWLEDGE, SKILLS AND ABILITIES

Required:

• 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).

EDUCATION AND EXPERIENCE

Required:

• 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.

Preferred:

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

WORK ENVIRONMENT/PHYSICAL DEMANDS

• Travel Requirements:Periodic local client visits
• Weight Lifting Requirements:20 lbs.
• Sedentary Work:Extended periods of sitting at a workstation while working on a computer.

RELATIONSHIPS

• Reports To:Supervisor, Contractual Oversight
• Directly Manages:None
• Internal Relationships:Interface with enterprise-wide staff at all levels
• External Relationships:Managed Care Organizations, Minnesota Department of Human Services, and Third-Party Administrator

The starting salary range for this position is between $26.00 and $32.00 per hour. Salary offers will typically be made in the listed range. The Company takes into consideration a candidate's education, training, and experience, as well as the position's work location, expected quality and quantity of work, required travel (if any), external market and internal value, including merit process and internal pay alignment when determining the salary for potential new team member's. In compliance with state and federal regulations, a potential new team member's salary history will not be used in compensation decisions.

EQUAL EMPLOYMENT OPPORTUNITY (EEO) STATEMENT

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.