Internal Auditor

Responsibilities:

Financial and Operational Audit:

• Conduct periodic audits of financial transactions, including premiums, capitation, claims, and provider payments.
• Review financial statements and accounting systems for accuracy and compliance.
• Verify revenue inflows, expenditures, reconciliations, and budget performance.

Compliance & Regulatory Monitoring:

• Ensure compliance with the NHIA Act (2022), NHIA guidelines, and other regulatory requirements.
• Review internal controls and procedures to ensure alignment with statutory standards.
• Monitor and follow up on the implementation of audit recommendations.

Claims & Medical Operations Audit:

• Audit healthcare provider claims to detect fraud, abuse, and irregularities.
• Review pre-authorizations, case management records, and enrollee utilization.
• Ensure proper documentation of tariff payments, encounter data, and reimbursement processes.

Risk Management:

• Identify operational, financial, and compliance risks.
• Recommend risk mitigation strategies and improve control mechanisms.
• Conduct fraud risk assessments and support investigations.

Performance Audit:

• Audit internal departments (IT, Provider Relations, Call Center, Enrolment, Underwriting, Finance, etc.) for efficiency.
• Evaluate the adequacy of internal controls and recommend improvements.

Reporting & Documentation:

• Prepare detailed audit reports with findings and recommendations.
• Maintain proper documentation for audit activities and investigations.
• Present audit findings to management and track implementation of corrective actions.

Investigation & Special Assignments:

• Investigate suspected fraud, misconduct, or policy breaches.
• Conduct spot checks at hospitals, client locations, and operational sites.
• Support management with ad-hoc audits and strategic initiatives.

Requirements:

• Master’s degree in accounting, Finance, or related discipline (minimum Second Class Upper).
• Professional certifications are mandatory: ICAN (ACA) or ACCA, CIA (Certified Internal Auditor) is a strong advantage, and CISA or CRISC will be an added advantage
• Minimum of 9 years post-NYSC relevant experience in internal auditing.
• At least 5 years in the Health Insurance (HMO), Insurance, or Financial Services sector.
• Previous experience auditing claims processing, provider networks, and premium income is highly desirable.
• Strong knowledge of NHIA regulations and HMO operations is an added advantage.
• Strong analytical and investigative abilities.
• Sound understanding of internal control frameworks.
• Ability to detect fraud, inconsistencies, and operational weaknesses.
• Proficiency in Microsoft Excel, audit software, and accounting tools.
• Excellent reporting, communication, and presentation skills.
• High level of integrity, confidentiality, and professionalism.
• Ability to work independently and manage multiple priorities.

What We Offer:

• Competitive salary package.
• Health insurance coverage.
• Professional development and continuous audit training.
• Transport allowance or fieldwork benefits (where applicable).
• Performance-based incentives and bonuses.

Location: Alausa-Ikeja, Lagos