Job Summary
- The Internal Auditor is responsible for independently evaluating the adequacy and effectiveness of internal controls and compliance with policies, procedures, and regulations across all departments within Noor Health HMO.
- The role involves carrying out audit assignments that span operational, financial, and administrative areas to ensure transparency, efficiency, and adherence to applicable standards.
- The Internal Auditor provides evidence-based recommendations to improve processes and supports the Head of Internal Audit in promoting accountability and control discipline throughout the organization.
Key Responsibilities
Organization-wide Audit Execution:
- Plan and execute comprehensive audits across all functional areas to assess
operational effectiveness, policy compliance, and control adequacy.
- Review departmental processes for procedural consistency, accuracy of records,
service delivery standards, and alignment with organizational goals.
- Audit claims processes to verify the authenticity of claims, compliance with policy terms, proper documentation, and alignment with benefit schedules.
- Conduct post-payment audits of healthcare providers to confirm services rendered, verify capitation and fee-for-service payments, and identify billing anomalies or potential abuse.
- Evaluate the control environment surrounding enrolee management, authorizations, and access to care across the provider network.
Regulatory and Internal Compliance:
- Monitor compliance with NHIA regulations and other statutory requirements relevant to HMO operations.
- Audit NHIA filings, enrolee onboarding processes, premium management, and regulatory correspondences for accuracy and completeness.
- Identify and escalate compliance breaches, recommending corrective measures. Financial and Operational Reviews
- Review financial records, vendor payments, petty cash, payroll, and procurement processes for accuracy, transparency, and compliance with internal procedures.
- Verify documentation supporting financial transactions and ensure proper accounting treatment and approvals are in place.
- Conduct periodic asset and inventory audits to confirm existence, usage, and accountability.
Control Monitoring and Reporting:
- Assess the design and effectiveness of internal controls across all departments and recommend practical improvements.
- Prepare clear, actionable audit reports with documented findings and proposed
resolutions.
- Follow up on the implementation of agreed audit recommendations and provide
status updates to the Head of Internal Audit.
Data Protection & Confidentiality:
- Uphold the highest standards of confidentiality in handling company-related
information, ensuring compliance with data protection laws and internal policies.
- Adhere to the company’s information security guidelines, including proper storage, transmission, and disposal of sensitive materials.
- Promptly report any suspected data breaches or unauthorized access to the
appropriate company authority.
- Participate in periodic data protection training to stay informed about evolving
security risks and best practices.
General Assignment:
- Execute any other duties and tasks that may be designated or assigned by the
Company.
- Participate in the knowledge sharing programme of the department and the
company.
- To provide support to your manager, Managing Director, and Vice Chairman as may be required towards serving the Board, Management, and staff members.
KPIs and Performance Metrics
- Completion rate of scheduled audit assignments (Target: ≥95% of audit plan).
- Timeliness and quality of audit reports (Target: within 10 working days post-audit).
- Implementation rate of audit recommendations (Target: ≥85%).
- Number of process improvement suggestions adopted.
- Incidence and resolution of audit-flagged issues.
Qualifications
Education:
- Bachelor’s Degree in Accounting, Finance, Economics, or a related discipline. ACA, ACCA, or CIA certification is required.
Experience
- 5–7 years of relevant internal audit experience, with a minimum of 3 years in the Health Maintenance Organization (HMO) or health insurance industry.
Skills and Competencies:
- Strong knowledge of internal audit practices and procedures.
- In-depth understanding of NHIA regulatory requirements and HMO
operations.
- Excellent documentation, reporting, and analytical skills.
- Strong attention to detail and professional ethics.
- Proficient in the use of Microsoft Office and accounting/audit tools.
- Ability to work independently and deliver within timelines.