Internal Auditor

Job Overview:
The Internal Auditor will be responsible for ensuring that all financial, operational, and regulatory processes within the organization comply with the National Health Insurance Authority (NHIA) Act, internal policies, and industry standards.

Duties and Responsibilities:
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. 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. 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. Identify operational, financial, and compliance risks. Recommend risk mitigation strategies and improve control mechanisms. Conduct fraud risk assessments and support investigations. Audit internal departments (IT, Provider Relations, Call Center, Enrolment, Underwriting, Finance, etc.) for efficiency. Evaluate the adequacy of internal controls and recommend improvements. 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. 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.

Required Qualifications:
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.

Educational Background:
Master’s degree in accounting, Finance, or related discipline (minimum Second Class Upper).

Experience:
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.

Languages:
English

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