About the Role
LEAD Enterprise Support Company Limited, a foremost Human Resources Solutions organization, is seeking a meticulous and experienced Internal Auditor to join our dynamic team. In this pivotal role, you will ensure that all financial, operational, and regulatory processes comply with the National Health Insurance Authority (NHIA) Act, internal policies, and industry standards, safeguarding our organizational integrity while optimizing operational efficiency across departments.
Key Responsibilities- Conduct periodic audits of financial transactions including premiums, capitation, claims, and provider payments to verify accuracy and budget performance.
- Ensure strict compliance with the NHIA Act, regulatory obligations, and internal control procedures.
- Audit healthcare provider claims, pre-authorizations, and enrollee utilization patterns to detect and prevent fraud, abuse, and irregularities.
- Identify operational, financial, and compliance risks while recommending robust mitigation strategies.
- Evaluate internal departments such as IT, Finance, and Underwriting for process efficiency and adequacy of internal controls.
- Prepare comprehensive audit reports, present outcomes to management, and conduct investigations into suspected policy breaches or unethical behavior.
- Bachelor's degree in Accounting, Finance, Economics, Business Administration, or a related field.
- Relevant professional qualifications such as ICAN, ACCA, CISA, CIA, or CRMA (completed or in-progress).
- Minimum of 8 years of audit experience, preferably within HMO/Health Insurance, healthcare provider audit, financial services, or insurance.
- Strong knowledge of NHIA regulations and HMO operations.
- Exceptional analytical, investigative, reporting, and communication skills with an uncompromising level of integrity.
- Competitive salary with performance-based bonuses.
- Comprehensive health insurance coverage.
- Professional development opportunities, continuous audit training, and field work benefits.