Claims Senior Internal Auditor Job
American Family Insurance - Madison, WI

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Job Title: Claims Senior Internal Auditor
Job ID: 03341
Division : Internal Audit Department
Work Location(s): United States-Wisconsin-Madison
Full/Part Time: Full-Time

Position Details

Preferred candidates will have experience evaluating internal controls. They will also have experience gathering, analyzing and documenting facts regarding fraud incidents.

Position Objective
Evaluates the adequacy and effectiveness of internal controls of claim operations. Conducts audits of high complexity. Determines whether the Claim division is performing their planning, accounting, custodial and control activities in compliance with management instructions and applicable policies, procedures, plans, laws and regulations. Determines whether corporate and departmental objectives are being met. Uses knowledge and understanding of claim operations, systems and programs to complete fidelity investigations. Reports audit findings objectively. Assists management in developing effective action plans that address audit concerns.

Primary Accountabilities
  • Fraud Investigation Auditing (30%)
  • Gathers and document facts regarding the fraud incident by interviewing individuals, reviewing claim files, and producing activating reports off of computer records.
  • Determines how fraud incident was conducted. Determines if internal procedures were insufficient to prevent or detect fraud or if internal controls were circumvented.
  • Collects, documents and presents to law enforcement agencies in order to expedite any legal actions against fraudulent perpetrator.
  • Customer Relations (20%)
  • Maintains audit customer contact throughout audit to keep customer informed of audit progress and any adverse findings to date.
  • Reports risk assessment and audit findings to divisional management. Answers divisional management / audit customer questions regarding risks and controls over the audited area.
  • Obtains response from appropriate Company officer that addresses negative audit findings and describes their plan of action to correct audit concerns.
  • Provides consulting to audit customers on risks, controls, and ideas on how to strengthen financial, operational and compliance controls.
  • Obtains information and prepares special reports as requested by management.
  • Risk Control & Assessment (15%)
  • Identifies risks in unit/department being audited by determining such factors as procedure consistency, database integrity, etc.
  • Identifies related controls by obtaining an understanding and documenting procedures using narratives and/or flowcharts. Completes Internal Audit's Risk Assessment to document risks and controls.The Risk Assessments will identify where risks are not adequately controlled.
  • Creates audit program by developing audit tests that will provide evidence as to how well key controls are working.
  • Provides Internal Audit management organized documentation of risk assessment performed by the auditor.
  • Control Testing (15%)
  • Conducts audit test procedures as outlined in detailed audit program.
  • Documents audit test results by recording the number of tests performed and the number of exceptions identified. Determine if the level of exceptions appears to be acceptable to management.
  • Analyzes audit test results by highlighting areas of exceptions and providing an opinion as to how well controls are operating.
  • Audit Concern Analysis / Findings (10%)
  • Identifies audit deviations by documenting the criteria (activity that should be occurring) versus the condition (actual result of activity).
  • Provides an explanation of the cause and impact of audit deviations.
  • Completes finding sheet that describes condition, criteria, deviation, effect or impact and management's action plan.
  • Project Management (10%)
  • Establishes budget, timelines, and milestones for each audit assignment.
  • Coordinates time schedule of auditor set by audit management and personnel in audit area.
  • Monitors progress against budget and schedule. Informs Internal Audit management of any deviations and works with management to develop corrective action plan.
Job Competencies
  • Achieve Results
  • Be Accountable
  • Maximize Customer Experience
  • Analytical Thinking
  • Innovation
  • Organizational Awareness
  • Planning & Organizing
  • Relationship Building
  • Technical Expertise
Education/Licenses/Designations
  • Bachelor Degree in Accounting, Finance, Risk Management, Information Systems or related field.
  • Must have Certified Fraud Examiner (CFE) certification or must obtain it within 12 months of hire.
Specialized Knowledge and Skills Requirements
  • Demonstrated experience managing and leading large complex projects.
  • Demonstrated extensive experience using audit techniques and methodologies.
  • Demonstrated solid experience in data analysis and outcome measurement
  • Demonstrated solid experience with Casualty, Property, and Physical Damage claims.
  • Extensive knowledge of computer concepts in personal computer and mainframe environments.
Travel Requirements
  • This position requires travel up to 25% of the time.
Company Information

Offer to selected candidate will be made contingent on the results of background checks.

A career move to join American Family Insurance may also mean a physical move for you. If you are selected for an interview, information will be provided on the level of relocation assistance available during the interview.

We offer a comprehensive benefits package that includes health, life and dental insurance, a 401(K) plan, paid holidays, vacation and sick leave and the opportunity for career development. If you would like to put your career in motion apply online today!

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American Family Insurance - 23 months ago - save job
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American Family Insurance offers auto, home, life & annuities, health, business and farm & ranch insurance. We’ve expanded...