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

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

Qualification

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.

KPIs and Performance Metrics

1. Completion rate of scheduled audit assignments (Target: ≥95% of audit plan).
2. Timeliness and quality of audit reports (Target: within 10 working days post-audit).
3. Implementation rate of audit recommendations (Target: ≥85%).
4. Number of process improvement suggestions adopted.
5. Incidence and resolution of audit-flagged issues